意大利面手腕损伤:过去、现在和未来

Q3 Medicine
Matei Ileana Rodica MD, PhD , Ciura-Capota Irina MD, PhD , Olariu Octavian , Alexandru Georgescu MD, PhD
{"title":"意大利面手腕损伤:过去、现在和未来","authors":"Matei Ileana Rodica MD, PhD ,&nbsp;Ciura-Capota Irina MD, PhD ,&nbsp;Olariu Octavian ,&nbsp;Alexandru Georgescu MD, PhD","doi":"10.1016/j.jhsg.2024.02.016","DOIUrl":null,"url":null,"abstract":"<div><div>This study will present our experience in treating “spaghetti wrist,” a complex injury of the distal forearm, with laceration of tendons, nerve(s), artery(es), and soft tissues. Also, we will present a review of the literature summarizing preoperative preparations, surgical and rehabilitation therapy, and immediate and delayed postoperative outcomes. The patients had complex injuries located in the distal 1/3 of the forearm, regardless of the physical etiologic agent, encompassing breach of the deep antebrachial fascia, at least one nerve, tendons, and, in some cases, arteries, along with single or multiple skin lacerations. The surgical procedure included surgical debridement, fasciotomy, decompression incisions, neurorrhaphy, tenorrhaphy, arteriorrhaphy, and soft tissue coverage protected by active/passive drainage. Depending on the anatomical structures reconstructed, the rehabilitation protocol was personalized, initially with dorsal immobilization in a plaster cast, followed by, as early as possible, passive and then active mobilization, under a single hand therapist’s control. Following prompt surgical intervention and adjusted personalized rehabilitation protocol, the results of even this type of challenging cases can be successful. The earlier the rehabilitation protocol was initiated, the better the results were. Patient adherence to the complex algorithm of treatment was also one of the most important prognostic aspects. What happens after the healing is another important aspect because the most devastating chronic complications, nervous deficits, must be evaluated and treated using modern possibilities.</div></div>","PeriodicalId":36920,"journal":{"name":"Journal of Hand Surgery Global Online","volume":"7 2","pages":"Pages 259-265"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Spaghetti Wrist Injury: Past, Present, and Future\",\"authors\":\"Matei Ileana Rodica MD, PhD ,&nbsp;Ciura-Capota Irina MD, PhD ,&nbsp;Olariu Octavian ,&nbsp;Alexandru Georgescu MD, PhD\",\"doi\":\"10.1016/j.jhsg.2024.02.016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>This study will present our experience in treating “spaghetti wrist,” a complex injury of the distal forearm, with laceration of tendons, nerve(s), artery(es), and soft tissues. Also, we will present a review of the literature summarizing preoperative preparations, surgical and rehabilitation therapy, and immediate and delayed postoperative outcomes. The patients had complex injuries located in the distal 1/3 of the forearm, regardless of the physical etiologic agent, encompassing breach of the deep antebrachial fascia, at least one nerve, tendons, and, in some cases, arteries, along with single or multiple skin lacerations. The surgical procedure included surgical debridement, fasciotomy, decompression incisions, neurorrhaphy, tenorrhaphy, arteriorrhaphy, and soft tissue coverage protected by active/passive drainage. Depending on the anatomical structures reconstructed, the rehabilitation protocol was personalized, initially with dorsal immobilization in a plaster cast, followed by, as early as possible, passive and then active mobilization, under a single hand therapist’s control. Following prompt surgical intervention and adjusted personalized rehabilitation protocol, the results of even this type of challenging cases can be successful. The earlier the rehabilitation protocol was initiated, the better the results were. Patient adherence to the complex algorithm of treatment was also one of the most important prognostic aspects. What happens after the healing is another important aspect because the most devastating chronic complications, nervous deficits, must be evaluated and treated using modern possibilities.</div></div>\",\"PeriodicalId\":36920,\"journal\":{\"name\":\"Journal of Hand Surgery Global Online\",\"volume\":\"7 2\",\"pages\":\"Pages 259-265\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hand Surgery Global Online\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2589514124000744\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hand Surgery Global Online","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2589514124000744","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

摘要

本研究将介绍我们治疗“意大利面腕”的经验,这是一种复杂的前臂远端损伤,伴有肌腱、神经、动脉和软组织撕裂伤。此外,我们将回顾文献,总结术前准备,手术和康复治疗,以及术后即时和延迟的结果。无论物理病因如何,患者均有位于前臂远端1/3的复杂损伤,包括前臂深筋膜破裂,至少一根神经,肌腱,在某些情况下,动脉,以及单个或多个皮肤撕裂伤。手术程序包括外科清创、筋膜切开术、减压切口、神经缝合、肌腱缝合、动脉缝合和主动/被动引流保护的软组织覆盖。根据重建的解剖结构,康复方案是个性化的,最初是用石膏固定背部,然后尽可能早地在单手治疗师的控制下进行被动和主动活动。通过及时的手术干预和调整个性化的康复方案,即使是这类具有挑战性的病例也可以取得成功。康复方案越早开始,效果越好。患者对复杂的治疗算法的依从性也是最重要的预后方面之一。愈合后发生的事情是另一个重要方面,因为最具破坏性的慢性并发症,神经缺陷,必须用现代的可能性来评估和治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Spaghetti Wrist Injury: Past, Present, and Future
This study will present our experience in treating “spaghetti wrist,” a complex injury of the distal forearm, with laceration of tendons, nerve(s), artery(es), and soft tissues. Also, we will present a review of the literature summarizing preoperative preparations, surgical and rehabilitation therapy, and immediate and delayed postoperative outcomes. The patients had complex injuries located in the distal 1/3 of the forearm, regardless of the physical etiologic agent, encompassing breach of the deep antebrachial fascia, at least one nerve, tendons, and, in some cases, arteries, along with single or multiple skin lacerations. The surgical procedure included surgical debridement, fasciotomy, decompression incisions, neurorrhaphy, tenorrhaphy, arteriorrhaphy, and soft tissue coverage protected by active/passive drainage. Depending on the anatomical structures reconstructed, the rehabilitation protocol was personalized, initially with dorsal immobilization in a plaster cast, followed by, as early as possible, passive and then active mobilization, under a single hand therapist’s control. Following prompt surgical intervention and adjusted personalized rehabilitation protocol, the results of even this type of challenging cases can be successful. The earlier the rehabilitation protocol was initiated, the better the results were. Patient adherence to the complex algorithm of treatment was also one of the most important prognostic aspects. What happens after the healing is another important aspect because the most devastating chronic complications, nervous deficits, must be evaluated and treated using modern possibilities.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
1.10
自引率
0.00%
发文量
111
审稿时长
12 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信