OPEN HAND FRACTURES - AN ANALYSIS OF THE RECOVERY OF ACTIVE MOTION AND OF COMPLICATIONS

Seventy-five of 104 patients who underwent operative fixation of open hand fractures were reviewed between 6 months and 7 years after injury (average, 17 months). There were 140 fractures involving 125 fingers. Results, evaluated on the basis of total active range of digital moti on achieved at final follow-up, correlated highly with severity of sof t tissue injury. When open fractures of comparable severity were contr asted between groups that did and did not require additional extension by incision to achieve acceptable reduction and stabilization, there was some additional loss of active range of motion in the surgically t reated group. Metacarpal fractures had significantly better outcomes t han phalangeal fractures. Fractures involving the proximal phalanx or the proximal interphalangeal joint had the poorest prognosis, especial ly when they were associated with tendon injury. There were significan t complications in 13 fingers. Infection and late amputation were rela ted to wound severity.