Duncan R W, Freeland A E, Jabaley M E, Meydrech E F
Department of Orthopaedic Surgery, University of Mississippi Medical Center, Jackson 39216-4505.
J Hand Surg Am. 1993 May;18(3):387-94. doi: 10.1016/0363-5023(93)90080-M.
Seventy-five of 104 patients who underwent operative fixation of open hand fractures were reviewed between 6 months and 7 years after injury (average, 17 months). There were 140 fractures involving 125 fingers. Results, evaluated on the basis of total active range of digital motion achieved at final follow-up, correlated highly with severity of soft tissue injury. When open fractures of comparable severity were contrasted between groups that did and did not require additional extension by incision to achieve acceptable reduction and stabilization, there was some additional loss of active range of motion in the surgically treated group. Metacarpal fractures had significantly better outcomes than phalangeal fractures. Fractures involving the proximal phalanx or the proximal interphalangeal joint had the poorest prognosis, especially when they were associated with tendon injury. There were significant complications in 13 fingers. Infection and late amputation were related to wound severity.
104例接受开放性手部骨折手术固定的患者中，75例在受伤后6个月至7年（平均17个月）接受了复查。共有140处骨折，累及125根手指。根据最终随访时手指总主动活动范围评估结果，与软组织损伤严重程度高度相关。当对比具有可比严重程度的开放性骨折时，在需要通过切口进行额外延长以实现可接受复位和固定的组与不需要的组之间，手术治疗组的主动活动范围有一些额外损失。掌骨骨折的结果明显优于指骨骨折。累及近节指骨或近端指间关节的骨折预后最差，尤其是与肌腱损伤相关时。13根手指出现了严重并发症。感染和晚期截肢与伤口严重程度有关。
