Factors affecting functional outcomes after surgery to repair extensive volar forearm lacerations with nerve injuries identified via quantitative and qualitative methods
Kenan Güvenç1, Erdem Ateş2, Zeynel Mert Asfuroğlu3
1Department of Orthopedics and Traumatology, Division of Hand Surgery, Eskişehir City Hospital, Eskişehir, Türkiye
2Department of Orthopedics and Traumatology, Mut State Hospital, Mersin, Türkiye
3Department of Orthopedics and Traumatology, Division of Hand Surgery, Mersin University Faculty of Medicine, Mersin, Türkiye
Keywords: Artery repair, intrinsic function, median nerve, sensation, ulnar nerve.
Abstract
Objectives: We aimed to investigate factors affecting the functional outcomes of patients with extensive volar forearm lacerations combined with nerve injuries who underwent surgery.
Patients and methods: Between January 2012 and December 2018, a total of 71 patients (58 males, 13 females; mean age: 41±12.1 years; range, 20 to 66 years) with extensive volar forearm lacerations treated in our center were retrospectively analyzed. Demographic data and injury details of the patients were recorded. The functional results were quantitatively evaluated using the Rosén-Lundborg protocol (RLP) and qualitatively evaluated using the Quick Disability of Arm, Shoulder, and Hand (QuickDASH) scale.
Results: The mean follow-up time 69.8±36.7 (range, 18 to 148) months. The mean final RLP and QuickDASH scores were 2.17±0.4 and 8.03±10.55, respectively. There were no major complications such as infection, necrosis, re-rupture of a structure, or amputation. Patients with combined median and ulnar nerve injuries had poorer RLP scores than the others. Patients with combined median and ulnar nerve injuries, combined radial and ulnar arterial injuries, and who were of low education status, had lower QuickDASH scores than the others.
Conclusion: The main factors affecting long-term functional outcomes are a combined artery or nerve injury and a low education status. Favorable results can be achieved with the cooperation of experienced surgeons and hand rehabilitation specialists for patients with severe hand injuries.
Citation: Güvenç K, Ateş E, Asfuroğlu ZM. Factors affecting functional outcomes after surgery to repair extensive volar forearm lacerations with nerve injuries identified via quantitative and qualitative methods. Jt Dis Relat Surg 2023;34(2):405-412. doi: 10.52312/jdrs.2023.1067.
The study protocol was approved by the Mersin University Faculty of Medicine Ethics Committee (date: 08.11.2019, no: 1221548). The study was conducted in accordance with the principles of the Declaration of Helsinki.
Idea/Concept, data collection, analysis, literature review: K.G.; Data collection, analysis, literatüre review: E.A.; Design, control/supervision, writing the article: Z.M.A.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
A written informed consent was obtained from each patient.
The data that support the findings of this study are available from the corresponding author upon reasonable request.