Clinical Analysis of Zone 5 Wrist Lacerations

Gu, Ja Hea; Jeong, Seong Ho; Han, Seung Kyu; Kim, Woo Kyung

Abstract

PURPOSE
We conduct a comprehensive review of demography, vector and cause of injury and results of zone 5 volar wrist lacerations.
MATERIALS AND METHODS
From July 2001 and June 2010, a total of 170 patients with zone 5 wrist lacerations were reviewed retrospectively. Sex, age, vector and cause of injury, injured structures and results were investigated. The correlations between the wound length, vector, cause of injury and number of injured structures were analyzed statistically.
RESULTS
The most common cause of injury is self-inflicted wrist injury followed by incidental accident, industrial accident, and the glass is the most common vector. Thirty six patients underwent primary repair only and 134 patients explored then underwent teno-neuro-arteriorraphy. Error rate between the preoperative and intraoperative evaluations was 30.6%, particularly greater than 50% in cases of flexor digitorum profundus and radial artery injuries. The most common injured structure was palmaris longus followed by flexor carpi radialis, flexor carpi ulnaris and median nerve. The cause and vector of injury did not correlate with the number of injured structures. Relationship between the mean length of wounds and the number of injured structures showed weak positive correlation.
CONCLUSION
In zone 5 wrist lacerations, exploration should be performed if the laceration involved over dermis layer. In addition to the surgical treatment, psychological care of these injuries is necessary.