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• W2144904581 abstract "Open fractures of the hand with segmental bone loss can be reconstructed either primarily or in a staged fashion. Primary bone grafting with osteosynthesis describes an early, single-stage surgery, during which the prerequisites of adequate debridement and immediate soft tissue coverage are also performed. This offers the advantage of fewer surgeries, reduced cost, immediate osseous stability allowing early active range of motion, and therefore, early return of function, without increasing the risk of infection. 1 Godina M. Early microsurgical reconstruction of complex trauma of the extremities. Plast Reconstr Surg. 1986; 78: 285-292 Crossref PubMed Scopus (875) Google Scholar , 2 Ninkovic M. Deetjen H. Ohler K. et al. Emergency free tissue transfer for severe upper extremity injuries. J Hand Surg Br. 1995; 20: 53-58 Crossref PubMed Scopus (69) Google Scholar , 3 Sabapathy S.R. Venkatramani H. Giesen T. et al. Primary bone grafting with pedicled flap cover for dorsal combined injuries of the digits. J Hand Surg Eur Vol. 2008; 33: 65-70 Crossref PubMed Scopus (12) Google Scholar , 4 Lister G. Scheker L. Emergency free flaps to the upper extremity. J Hand Surg Am. 1988; 13: 22-28 Abstract Full Text PDF PubMed Scopus (151) Google Scholar , 5 Scheker L.R. Langley S.J. Martin D.L. et al. Primary extensor tendon reconstruction in dorsal hand defects requiring free flaps. J Hand Surg Br. 1993; 18: 568-575 Crossref PubMed Scopus (43) Google Scholar , 6 Sundine M. Scheker L.R. A comparison of immediate and staged reconstruction of the dorsum of the hand. J Hand Surg Br. 1996; 21: 216-221 Crossref PubMed Scopus (48) Google Scholar , 7 Gonzalez M.H. McKay W. Hall Jr., R.F. Low-velocity gunshot wounds of the metacarpal: treatment by early stable fixation and bone grafting. J Hand Surg Am. 1993; 18: 267-270 Abstract Full Text PDF PubMed Scopus (37) Google Scholar , 8 Gonzalez M.H. Hall M. Hall Jr., R.F. Low-velocity gunshot wounds of the proximal phalanx: treatment by early stable fixation. J Hand Surg Am. 1998; 23: 150-155 Abstract Full Text PDF PubMed Scopus (28) Google Scholar , 9 Kömürcü M. Alemdaroğlu B. Kürklü M. et al. Handgun injuries with metacarpal and proximal phalangeal fractures: early definitive treatment. Int Orthop. 2008; 32: 257-262 Crossref PubMed Scopus (13) Google Scholar , 10 Saint-Cyr M. Miranda D. Gonzalez R. et al. Immediate corticocancellous bone autografting in segmental bone defects of the hand. J Hand Surg Br. 2006; 31: 168-177 Crossref PubMed Scopus (21) Google Scholar , 11 Stahl S. Lerner A. Kaufman T. Immediate autografting of bone in open fractures with bone loss of the hand: a preliminary report. Case reports. Scand J Plast Reconstr Surg Hand Surg. 1999; 33: 117-122 Crossref PubMed Scopus (19) Google Scholar , 12 Stahl S. Lotter O. Stahl A.S. et al. Immediate reconstruction of complex hand trauma with iliac crest bone graft and 2 pedicled fasciocutaneous skin flaps: a case report. Eplasty. 2010; 10: e21 PubMed Google Scholar Staged reconstruction requires 2 to 3 consecutive surgeries to allow stabilization of soft tissues, and some feel that this routinely reduces infectious risk. Proponents of staged reconstruction fear that infection may accompany the primary placement of nonvascular bone graft to the wound bed, with concern that this remains a contaminated environment without staged debridements. 13 Burkhalter W.E. Butler B. Metz W. et al. Experiences with delayed primary closure of war wounds of the hand in Viet Nam. J Bone Joint Surg Am. 1968; 50: 945-954 PubMed Google Scholar , 14 Freeland A.E. Jabaley M.E. Burkhalter W.E. et al. Delayed primary bone grafting in the hand and wrist after traumatic bone loss. J Hand Surg Am. 1984; 9: 22-28 Abstract Full Text PDF Scopus (37) Google Scholar Therefore, radical and thorough debridement of the wound under tourniquet control is perhaps the most important step in confirming that the defect is amenable to primary bone grafting. 1 Godina M. Early microsurgical reconstruction of complex trauma of the extremities. Plast Reconstr Surg. 1986; 78: 285-292 Crossref PubMed Scopus (875) Google Scholar , 2 Ninkovic M. Deetjen H. Ohler K. et al. Emergency free tissue transfer for severe upper extremity injuries. J Hand Surg Br. 1995; 20: 53-58 Crossref PubMed Scopus (69) Google Scholar , 3 Sabapathy S.R. Venkatramani H. Giesen T. et al. Primary bone grafting with pedicled flap cover for dorsal combined injuries of the digits. J Hand Surg Eur Vol. 2008; 33: 65-70 Crossref PubMed Scopus (12) Google Scholar" @default.
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• W2144904581 title "Primary Bone Grafting in Open Fractures With Segmental Bone Loss" @default.
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