Crush versus sharp injuries in spaghetti wrist trauma: Analysis of 13 years of experience

Abstract

Spaghetti wrist injury pertains to profound volar wrist lacerations with the potential to disrupt a complex interplay of anatomical structures. In our study, we wanted to highlight the importance of etiological factors that have not been previously investigated for this type of injury. Patients diagnosed with spaghetti wrist injury between 01.01.2010-01.01.2023 who subsequently underwent surgical intervention at our institution were identified from the database of our institution and relevant data has been recorded. Contact information for all patients was extracted, and patients were invited for follow-up examinations. A comprehensive hand examination was conducted for patients attending the follow-up assessment. Finally, patients completed the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire for a comprehensive assessment. Fifty-three patients were included in our study. The mean age of the patients was 44. The ratio of females to males is 7/46. The mean follow-up period was 7 months. The ratio of the left hand to the right hand is 21/32. Forty-two sharp and 11 crush injuries are present. The range of motion values of sharp injuries were significantly better than those of crush injuries. Opposition results were compared with each other, but no significant difference was found. However, when intrinsic muscle function was compared, ulnar nerve function recovered significantly worse after crush injury. According to both the Semmes-Weinstein Monofilament Test and two-point discrimination, sharp injuries healed with significantly better sensory outcomes. DASH questionnaire scores were compared, and no significant difference was found. Sharp injuries showed significantly better functional results than crush injuries. Our study contributes substantively to the existing literature on spaghetti injuries, particularly by examining previously unexplored areas such as injury aetiology and presents comprehensive findings on these subjects.

Keywords

• Crush
• flexor tendon
• function
• sharp
• spaghetti wrist

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