Küster H H, Martini A K
Aktuelle Traumatol. 1983 Jun;13(3):106-10.
Stab wounds of the hand should not be dismissed lightly as trifles. It may well be that deep underlying structures are destroyed even if the injury is very small, hardly visible and thus seems to be negligible. As a matter of fact, such injuries are easily overlooked particularly by the patient himself and, possibly, also by an inexperienced nurse or examiner. The most serious consequences can arise from non-diagnosed complete and incomplete injuries of tendons and nerves. The authors emphasise the importance of paying close attention to complete or partial injuries of the extensor tendons and nerves. If at all possible, these should be looked after immediately. Particular emphasis is placed by the authors on complete or partial injuries in the region of the proximal interphalangeal joints, involving the risk of a typical "buttonhole" deformity. Among the typical sequels of a stab injury are lesions of the nerves of the fingers as well as of the flexor and extensor tendons, quite apart from the general danger of an infection. Whereas injuries of the extensor tendons do not place great demands on the skill of the surgeon, injuries of the tendons and nerves in the flexor region are the domain of the hand surgeon.
手部刺伤不应被轻易视为小事而不予重视。即便伤口很小，几乎看不见，因而看似微不足道，但深部潜在结构很可能已遭破坏。事实上，此类损伤很容易被忽视，尤其是患者本人，也可能被经验不足的护士或检查人员忽视。肌腱和神经的完全性及不完全性损伤若未被诊断出来，可能会导致最严重的后果。作者强调密切关注伸肌腱和神经的完全性或部分性损伤的重要性。如果可能的话，应立即对这些损伤进行处理。作者特别强调近端指间关节区域的完全性或部分性损伤，这类损伤存在典型“扣眼”畸形的风险。除了感染的一般风险外，刺伤的典型后遗症还包括手指神经以及屈肌腱和伸肌腱的损伤。伸肌腱损伤对外科医生的技术要求不高，而屈肌区域的肌腱和神经损伤则是手外科医生的领域。
