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ORIGINAL ARTICLE
Year : 2020  |  Volume : 28  |  Issue : 1  |  Page : 44-50

Surgical Validation of High-Resolution Ultrasonography in Detection of Missed Tendon and Nerve Injuries after Penetrating Wounds of Hand and Wrist


1 Department of Burns, Plastic and Reconstructive Surgery, Adesh Medical College, Kurukshetra, Haryana, India
2 Department of Burns, Plastic and Reconstructive Surgery, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, India
3 Department of Surgery, Adesh Medical College, Kurukshetra, Haryana, India
4 Department of Radiodiagnosis, Adesh Medical College, Kurukshetra, Haryana, India

Correspondence Address:
Dr. Mohd Altaf Mir
Department of Burns, Plastic and Reconstructive Surgery, Adesh Medical College, Mohri, Kurukshetra - 136 135, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjps.tjps_86_18

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Background: To surgically validate high-resolution ultrasonography (USG) in the detection of missed tendon and nerve injuries after penetrating wounds of the hand and wrist. Materials and Methods: Patients with penetrating wounds of the hand and wrist were examined to determine the location of injury, size, and depth of the wound, probable tendons or nerves involved. The selected cases underwent high-resolution ultrasound of the affected part. Injuries detected were noted. The sensitivity, specificity, positive predictive value, and negative predictive values of the high resolution of ultrasound in preoperative detection of tendon and nerve injuries were calculated against the gold standard of intraoperative confirmation. Results: Fifty patients with penetrating injuries to the hand and wrist with the mean age 28.3 ± 4.7 years were admitted. The high-resolution USG of all the 50 patients 33 (66%) were found to have isolated tendon injury and 14 cases were found to have isolated nerve injury, whereas three cases were found to have both tendon and nerve injury. The injuries were compared with injuries confirmed on intraoperative exploration. The calculated sensitivity, specificity, positive predictive value, and negative predictive value of high-resolution USG for diagnosing the tendon injuries were 97.22%, 98.42%, 97.22%, and 98.42%, respectively. The calculated sensitivity, specificity, positive predictive value, and negative predictive value of high-resolution USG for diagnosing the nerve injuries were 85%, 92.85%, 89.47%, and 89.65%, respectively. Conclusion: It is concluded that high-resolution USG is significantly cheaper and dynamic diagnostic modality which can be used to provide additional information for diagnosing tendon and nerve tears and their location and types in cases of penetrating wounds of the hand and wrist.


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