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Predicting Amputation and Multiple Debridements in Tooth Knuckle Injuries.
H R Smith1, C Conyard2, J Loveridge2
1* College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.
The Journal of Hand Surgery Asian-Pacific Volume
|February 15, 2019
Summary
Tooth knuckle injuries can lead to amputation or multiple surgeries. Osteomyelitis is a key predictor for amputation, while delayed treatment and diabetes increase the need for repeat debridements, aiding risk prediction.
Area of Science:
- Orthopedic Surgery
- Trauma Care
- Infectious Disease
Background:
- Tooth knuckle injuries pose significant treatment challenges, including high costs and potential amputation.
- Existing literature lacks comprehensive understanding of factors predicting amputation and multiple debridements for these injuries.
Purpose of the Study:
- To identify predictors for amputation and the need for multiple surgical debridements in patients with tooth knuckle injuries.
- To develop predictive models for patient risk stratification.
Main Methods:
- A historic cohort study involving 321 patients treated for tooth knuckle injuries.
- Collection of 21 demographic, clinical, and laboratory variables.
- Multivariate logistic regression analysis to assess predictor-outcome relationships.
Main Results:
- 1.6% of patients required amputation, and 25% needed multiple debridements.
- Osteomyelitis was a strong predictor of amputation (Odds Ratio = 35).
- Delayed presentation (OR = 1.1) and diabetes (OR = 2.6) significantly increased the risk of requiring multiple debridements.
Conclusions:
- Predictive models accurately identified patients at high risk for amputation and multiple debridements.
- Reducing osteomyelitis and addressing delayed presentations are crucial for minimizing amputation and reoperation rates.
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