[Management of open, potentially infected hand injuries with bone defect by delayed early bone substitution]

Authors make an analogy between the principles of treatment of the fresh, potentially infected injuries with bone and soft tissue defects and of the already developed manifest infection of the hand. The principles of treatment are essentially the same. First of all the fixateur externe and the antibiotics containing globules are suggested for the sanation and prevention of the disease equally. Attention is called to the fact, that better results can be expected from the prophylaxis than from the attempts to make the process reversible. The beneficial synergism of the extrafocal fixation and the intrafocally acting antibiotics will help. One of the secrets of the good late functional results is the early restitution of the architecture of the bones of the hand. For this, the authors suggest the most modern replacement of bone in the form of primary delayed cancellous bone plasty, performed within two weeks.