Open hand fractures: Prognosis and classification

T. V. Swanson, Robert M Szabo, D. D. Anderson

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Two hundred open fractures distal to the carpus in one hundred twenty-one patients were studied retrospectively. One hundred seventy-three fractures were followed-up to complete bony union, which occurred at a median period of seven weeks. Ninety-seven total complications included nine wound infections in seven patients, eighteen malunions, seventeen delayed or nonunions, twenty-three fixation problems, and two late amputations. Infection rate increased in the presence of wound contamination, delay in treatment greater than twenty-four hours, or systemic illness. It was not increased by presence of internal fixation, immediate wound closure, large wound size, tendon/nerve/vascular injury, or high-energy mechanism. We suggest a classification predictive of infection: type I: Clean wound and no systemic illness; type II: Contaminated wound, delay in treatment greater than twenty-four hours, or significant systemic illness. We recommend choosing fracture stabilization on the basis of the mechanical needs of the fracture, regardless of wound size, injury energy, or contamination. Immediate wound closure is appropriate for type I injuries and delayed closure should be reserved for type II wounds.

Original languageEnglish (US)
Pages (from-to)101-107
Number of pages7
JournalJournal of Hand Surgery
Volume16
Issue number1
StatePublished - 1991

Fingerprint

Open Fractures
Hand
Wounds and Injuries
Vascular System Injuries
Wound Infection
Infection
Amputation
Tendons

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Swanson, T. V., Szabo, R. M., & Anderson, D. D. (1991). Open hand fractures: Prognosis and classification. Journal of Hand Surgery, 16(1), 101-107.

Open hand fractures : Prognosis and classification. / Swanson, T. V.; Szabo, Robert M; Anderson, D. D.

In: Journal of Hand Surgery, Vol. 16, No. 1, 1991, p. 101-107.

Research output: Contribution to journalArticle

Swanson, TV, Szabo, RM & Anderson, DD 1991, 'Open hand fractures: Prognosis and classification', Journal of Hand Surgery, vol. 16, no. 1, pp. 101-107.
Swanson, T. V. ; Szabo, Robert M ; Anderson, D. D. / Open hand fractures : Prognosis and classification. In: Journal of Hand Surgery. 1991 ; Vol. 16, No. 1. pp. 101-107.
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