J Hand Microsurg 2016; 08(03): 127-133
DOI: 10.1055/s-0036-1586487
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Treatment and Postsurgery Functional Outcome of Spaghetti Wrist

Hamed Yazdanshenas
1   Departments of Orthopedic Surgery and Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, California, United States
2   Department of Orthopedic Surgery, University of California, Los Angeles (UCLA), California, United States
,
Alireza Fadaee Naeeni
3   Department of Plastic and Reconstructive Surgery, Guilan University of Medical Sciences, Gilan, Iran
,
Anousheh Ashouri
4   Department of Internal Medicine-Pediatrics, Loma Linda University, Loma Linda, California, United States
,
Eleby R. Washington III
1   Departments of Orthopedic Surgery and Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, California, United States
,
Arya Nick Shamie
2   Department of Orthopedic Surgery, University of California, Los Angeles (UCLA), California, United States
,
Kodi Azari
2   Department of Orthopedic Surgery, University of California, Los Angeles (UCLA), California, United States
› Author Affiliations
Further Information

Publication History

30 November 2015

30 June 2016

Publication Date:
17 August 2016 (online)

Abstract

Background The outcomes of treating severe wrist injuries are not well understood and despite their complexity and prevalence, particularly among young adults, spaghetti wrist is rarely investigated. The aim of this study is to evaluate the postsurgery, functional outcome of spaghetti wrist injuries.

Material and Methods In this prospective cross-sectional study, 153 patients with spaghetti wrist injuries were followed up for approximately 20 months and were assessed regarding returning to work and postsurgical functional outcomes that included tendon functionality, opposition, intrinsic function, deformity, sensation, and grip strength.

Results The mean age was 28.3 ± 5 years. The most common cause of injury was glass window panes and bottles. Moreover, the most commonly involved structures were the tendons of flexor digitorum superficialis 3, 4, and 5. During the follow-up, the tendon functionality in 120 (78%), opposition in 115 (75.1%), and intrinsic function in 62 (40.5%) were “excellent.” Hand sensation was “fair” in 75 patients (49.1%), “good” in 46 patients (30%), and “excellent” in 28 patients (18.3%). The average return time to activities of daily living was 10 months.

Conclusion In this study, worse outcomes were seen in older patients and those with higher number of damaged structures (especially nerves).

Note

This article describes original work and is not under consideration by any other journal. All authors approved the article and this submission. The authors of this study declare no conflict of interest.


 
  • References

  • 1 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) 1609-1617
  • 2 Bukhari AJ, Saleem M, Bhutta AR, Khan AZ, Abid KJ. Spaghetti wrist: management and outcome. J Coll Physicians Surg Pak 2004; 14 (10) 608-611
  • 3 Kabak S, Halici M, Baktir A, Türk CY, Avşarogullari L. Results of treatment of the extensive volar wrist lacerations: ‘the spaghetti wrist’. Eur J Emerg Med 2002; 9 (1) 71-76
  • 4 Kumar-Kempelingaiah A. Epidemiology and classification of extensive volar wrist lacerations: The “spaghetti wrist.”. Internet Journal of Third World Medicine. 2003; 1 (2) 1 DOI: http://dx.doi.org/10.5580/12c8.
  • 5 Puckett CL, Meyer VH. Results of treatment of extensive volar wrist lacerations: the spaghetti wrist. Plast Reconstr Surg 1985; 75 (5) 714-721
  • 6 Widgerow AD. Full-house/spaghetti wrist injuries. Analysis of results. S Afr J Surg 1990; 28 (1) 6-10
  • 7 Yildirim A, Nas K. Evaluation of postoperative early mobilization in patients with repaired flexor tendons of the wrist, the spaghetti wrist. J Back Musculoskeletal Rehabil 2010; 23 (4) 193-200
  • 8 El-Lamie KK, Younes TB. Spaghetti wrist: Good prognosis with adequate surgical technique and early physiotherapy. Egypt Journal of Plast Reconstr Surgery. 2010; 34 (2) 161-166
  • 9 Hudson DA, de Jager LT. The spaghetti wrist. Simultaneous laceration of the median and ulnar nerves with flexor tendons at the wrist. J Hand Surg [Br] 1993; 18 (2) 171-173
  • 10 Slattery PG. The modified Kleinert splint in zone II flexor tendon injuries. J Hand Surg [Br] 1988; 13 (3) 273-276
  • 11 Noaman HH. Management and functional outcomes of combined injuries of flexor tendons, nerves, and vessels at the wrist. Microsurgery 2007; 27 (6) 536-543
  • 12 Germann G, Wind G, Harth A. [The DASH(Disability of Arm-Shoulder-Hand) Questionnaire—a new instrument for evaluating upper extremity treatment outcome]. Handchir Mikrochir Plast Chir 1999; 31 (3) 149-152
  • 13 Weinzweig N, Chin G, Mead M, Gonzalez M. “Spaghetti wrist”: management and results. Plast Reconstr Surg 1998; 102 (1) 96-102
  • 14 Parviz M, Hadi B. Management and results of extensive volar wrist lacerations. MJIRI 2006; 20 (1) 5-7
  • 15 Sebastin SJ, Puhaindran ME, Lim AY, Lim IJ, Bee WH. The prevalence of absence of the palmaris longus—a study in a Chinese population and a review of the literature. J Hand Surg [Br] 2005; 30 (5) 525-527
  • 16 Yüksel F, Peker F, Açikel C, CelIköz B. Secondhand management of “spaghetti wrist”: do not hesitate to explore. Ann Plast Surg 2002; 49 (5) 500-504 , discussion 504–505