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Spaghetti wrist: management and outcome.
Azhar Jawaid Bukhari1, Mohammad Saleem, Aamer Riaz Bhutta
1Department of Surgery, Sir Ganga Ram Hospital, Lahore. azhar104@hotmail.com
Summary
Emergency management of spaghetti wrist injuries through immediate primary repair yields good outcomes. Effective physiotherapy and patient compliance are crucial for optimal functional recovery and wrist joint mobility.
Area of Science:
- Hand surgery
- Trauma surgery
- Microsurgery
Background:
- The 'spaghetti wrist' describes sharp, clean-cut volar forearm lacerations involving multiple vital structures.
- Prompt surgical intervention is critical for preserving function in these complex injuries.
Purpose of the Study:
- To evaluate the outcomes of emergency management for spaghetti wrist injuries.
- To assess the efficacy of immediate primary repair in restoring function.
Main Methods:
- A descriptive study was conducted on 10 patients (aged 14-38 years) with spaghetti wrist injuries treated within 6 hours.
- Follow-up included clinical assessment and nerve conduction studies over one year.
- Recovery was evaluated using standardized scales for sensory, motor, and tendon function.
Main Results:
- Accidental injuries, often from broken glass or kite strings, involved an average of 8.2 structures per patient.
- Median and ulnar nerves were frequently involved, alongside wrist flexors.
- All patients achieved full range of motion and power in wrist joints, with good overall functional results.
Conclusions:
- Immediate primary repair of spaghetti wrist injuries is a safe and effective treatment.
- Good physiotherapy, close follow-up, and patient compliance significantly influence outcomes.
- Clinical and functional assessments are more appropriate for evaluating recovery than neurophysiological studies alone.