Epidemiological Profile and Surgical Outcomes in Patients with Spaghetti Wrist Injury: A Retrospective Study
Main Article Content
Abstract
Background: Spaghetti wrist is one of the most complex and disabling injuries of the upper extremity. Despite its surgical relevance, epidemiological and prognostic data remain limited.
Objective: To determine the epidemiological profile and prevalence of surgical reintervention in patients with spaghetti wrist injuries.
Methods: A retrospective, cross-sectional, and descriptive study was conducted at the “Dr. Victorio de la Fuente Narváez” Trauma Hospital, Mexico City. Medical records of patients with volar wrist injuries (zone V flexor) from January 2016 to December 2019 were reviewed. Continuous variables were expressed as mean ± standard deviation; categorical variables as frequencies and percentages. Significance was set at p ≤ 0.05.
Results: A total of 119 patients were included, 80.7% male (mean age 29.2 ± 12.4 years). Most injuries were accidental (77.3%), caused by glass (63%), and occurred at home (61.3%). The dominant side was affected in 88.2%. The reintervention rate was 7.6%. The most frequently injured structures were the flexor carpi ulnaris (59.7%), palmaris longus (59.7%), and ulnar artery (56.3%). No significant demographic or clinical differences were found between reoperated and non-reoperated patients.
Conclusion: Patients with spaghetti wrist injury treated at our institution shared similar demographic and clinical patterns to those reported internationally. Early surgical repair and adequate rehabilitation correlated with a low prevalence of reintervention.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Griffin M, Hindocha S, Jordan D, Saleh M, Khan W. An overview of the management of flexor tendon injuries. Open Orthop J. 2012;6(1):28–35.
II. Koshy K, Prakash R, Luckiewicz A, Alamouti R, Nikkhah D. An extensive volar forearm laceration—the spaghetti wrist: a systematic review. JPRAS Open. 2018;18:1–17.
III. Chin G, Weinzweig N, Mead M, Gonzalez M. Spaghetti wrist: management and results. Plast Reconstr Surg. 1998;102(1):96–102.
IV. Nasab SA, Sarrafan N, Saeidian SR, Emami H. Functional outcome of flexor tendon repair at Zone 5 with early mobilization. Pak J Med Sci. 2013;29(1):43–46.
V. Jaquet JB, van der Jagt I, Kuypers PD, Schreuders TA, Kalmijn AR, Hovius SE. Spaghetti wrist trauma: functional recovery, return to work, and psychological effects. Plast Reconstr Surg. 2005;115(6):1609–17.
VI. Demirdover C, et al. Surgical treatment and functional outcomes of multicomponent soft tissue injuries of the wrist. Hand Surg Rehabil. 2018;37(3):160–6.
VII. Tapp M, Wenzinger E, Tarabishy S, Ricci J, Herrera FA. The epidemiology of upper extremity nerve injuries and associated costs in the US. Ann Plast Surg. 2019;83(6):676–80.
VIII. Lee CH, et al. Injury patterns and the role of tendons in protecting neurovascular structures in wrist injuries. Injury. 2016;47(6):1264–9.
IX. Ersen B, Kahveci R, Saki MC, Tunali O, Aksu I. Analysis of suicide attempts by wrist cutting: a retrospective analysis. Eur J Trauma Emerg Surg. 2015;41(1):75–9.
X. Hundepool CA, Ultee J, Nijhuis T, Houpt P, et al. Prognostic factors for outcome after median and ulnar nerve injuries. J Plast Reconstr Aesthet Surg. 2015;68(1):1–8.
XI. Yazdanshenas H, Naeeni AF, Ashouri A, Washington ER. Treatment and postsurgery outcome of spaghetti wrist. J Hand Microsurg. 2016;8(3):127–33.
XII. Ishak A, Rajangam A, Khajuria A. The evidence-base for the management of flexor tendon injuries of the hand: review. Ann Med Surg (Lond). 2019;48:1–6.
XIII. Klifto CS, Bookman J, Paksima N. Postsurgical rehabilitation of flexor tendon injuries. J Hand Surg Am. 2019;44(8):693–700.
XIV. Rodríguez GM, Wormald JCR, Furniss D. Patient-reported outcome measures after hand trauma: a systematic review. J Hand Surg Eur Vol. 2018;43(9):964–73.
XV. Wormald JCR, Rodrigues JN, Smith C, Furniss D. The DASH and MHQ are highly variable in spaghetti wrist injury: a systematic review. J Plast Reconstr Aesthet Surg. 2019;72(1):63–73.