Predicting Amputation and Multiple Debridements in Tooth Knuckle Injuries.
Amputation
Clenched fist injury
Health care costs
Tooth knuckle injury
Journal
The journal of hand surgery Asian-Pacific volume
ISSN: 2424-8363
Titre abrégé: J Hand Surg Asian Pac Vol
Pays: Singapore
ID NLM: 101688432
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
entrez:
15
2
2019
pubmed:
15
2
2019
medline:
9
4
2019
Statut:
ppublish
Résumé
Tooth knuckle injuries can be expensive to treat and may necessitate amputation in some cases. Several limitations exist in the literature regarding our knowledge around the factors predicting amputation and the need for multiple debridements in treating this injury. A historic cohort study of 321 patients treated for tooth knuckle injuries was undertaken. Twenty-one demographic, clinical and laboratory variables were collected. Two outcome measurements were collected - the need for amputation and the need for more than one surgical debridement. A multivariate logistic regression was performed to determine the relationship between the predictor variables and the outcome measurements. Of the 321 patients examined, 1.6% required amputations and 25% required multiple debridements. Osteomyelitis was found to be a major predictor for amputation in these patients (OR = 35). Delayed presentation (OR = 1.1) and diabetes (OR = 2.6) were found to significantly increase the risk of requiring multiple debridements. Our models were able to predict what patients were at the greatest risk for amputation and multiple debridement. Reducing rates of osteomyelitis and delays in presentation may help reduce the incidence of amputation and reoperation in this injury.
Sections du résumé
BACKGROUND
BACKGROUND
Tooth knuckle injuries can be expensive to treat and may necessitate amputation in some cases. Several limitations exist in the literature regarding our knowledge around the factors predicting amputation and the need for multiple debridements in treating this injury.
METHODS
METHODS
A historic cohort study of 321 patients treated for tooth knuckle injuries was undertaken. Twenty-one demographic, clinical and laboratory variables were collected. Two outcome measurements were collected - the need for amputation and the need for more than one surgical debridement. A multivariate logistic regression was performed to determine the relationship between the predictor variables and the outcome measurements.
RESULTS
RESULTS
Of the 321 patients examined, 1.6% required amputations and 25% required multiple debridements. Osteomyelitis was found to be a major predictor for amputation in these patients (OR = 35). Delayed presentation (OR = 1.1) and diabetes (OR = 2.6) were found to significantly increase the risk of requiring multiple debridements.
CONCLUSIONS
CONCLUSIONS
Our models were able to predict what patients were at the greatest risk for amputation and multiple debridement. Reducing rates of osteomyelitis and delays in presentation may help reduce the incidence of amputation and reoperation in this injury.
Identifiants
pubmed: 30760142
doi: 10.1142/S2424835519500024
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM