Shahab Shahid
Junior Doctor, Barts Health NHS Trust. London, UK
Title: First Webspace Trauma- Development of a Prognostic Score
Biography
Biography: Shahab Shahid
Abstract
Statement of the Problem:
The first web space and thumb is an essential area for hand function and contains a number of vital neurovascular and muscular structures. Injury has the potential to cause significant impairment of hand function.
Methodology & Theoretical Orientation:
We retrospectively collected the data of 102 patients who suffered first webspace trauma. Data from hand therapy appointments for this cohort has enabled us to analyze the importance of each of the components of the first web-space for overall hand function. We liaised with the hand therapy team at the Royal London Hospital and devised a prognostic score, based on the extent of recovery of hand function.
Findings:
68% of cases were male with an average age of 29. Injuries to the volar aspect were more common (58%) than the dorsal aspect (27%). 70% of injuries were lacerations and 8% were abscesses. Thumb injuries were a major component, with flexor thumb injuries in zone 2 (42%) and zone 3 (42%).
Conclusion & Significance:
Factors linked to poor function include nerve involvement, infection, multiple injuries, skin loss, compound fracture and amputation. Factors linked to better function included clean-cut injuries, short time between injury and therapy, no tendon/bone/nerve involvement, and good quality digital nerve repair.