RESUMO
Reconstruction of the radial border of the index metacarpophalangeal (MCP) joint after band saw amputation is described. The entire radial MCP collateral ligament unit was cleanly retained within the amputated segment, still attached to wafers of corticocancellous bone from the radial aspect of the metacarpal head and base of the proximal phalanx. Acute bone to bone osteosynthesis of the amputated segment led to successful osseous integration of both bone fragments and restoration of stability of the joint. Surgical repair of the radial collateral ligament of the index MCP joint is crucial in achieving an optimal outcome after such an injury.
Assuntos
Amputação Traumática/cirurgia , Ligamentos Colaterais/lesões , Traumatismos dos Dedos/cirurgia , Articulação Metacarpofalângica/lesões , Procedimentos de Cirurgia Plástica/métodos , Acidentes de Trabalho , Adulto , Ligamentos Colaterais/diagnóstico por imagem , Ligamentos Colaterais/cirurgia , Traumatismos dos Dedos/diagnóstico por imagem , Humanos , Masculino , Articulação Metacarpofalângica/diagnóstico por imagem , Articulação Metacarpofalângica/cirurgia , RadiografiaRESUMO
BACKGROUND: While treating an unusual amputation caused by a meat band saw in a 35-year-old butcher, we sought information from the medical literature that would be useful to other physicians who might encounter similar occupational injuries. METHODS: Using the Medline database and relevant search terms, we reviewed the literature concerning occupational saw blade injuries and porcine microbiology as they related to this injury. RESULTS: Among meat workers using powered cutting equipment, hand injuries and distal fingertip amputations appear to be common. The greatest risk for a wound infection after open exposure to raw pork meat appears primarily related to environmental flora rather than enteric-borne porcine pathogens. CONCLUSIONS: Decision-making strategy when formulating a treatment plan for debridement or reconstruction of saw blade amputations should rely on a detailed understanding of the injury and occupational environment to achieve an optimal patient outcome. When considering operative and antibiotic treatment for porcine meat-related amputation injury, surgeons should adhere to open fracture-related guidelines, since porcine-borne illnesses are most often caused by ingestion rather than transcutaneous inoculation.
