Spaghetti Wrist (Laceration of the Volar Forearm)

 

Number of potential structures that may be injured: 16 (Katz)

 

Number of structures that need to be damaged to qualify: varies from >= 3 to >= 10 (Weinzweig reports an average of 7.8 structures)

 

Most frequently injured structures (Weinzweig et al):

(1) flexor carpi ulnaris

(2) flexor digitorum superficialis

(3) median nerve

(4) ulnar nerve

(5) ulnar artery

 

Mechanism of injury:

(1) knife

(2) axe or chainsaw

(3) suicide attempt

(4) broken glass

(5) snowboard

(6) industrial accident

 

Factors affecting outcome:

(1) number of cuts

(2) number of structures involved

(3) mangling of tissues (vs clean cut)

(4) significant nerve injury

(5) extent of environmental contamination

(6) quality and promptness of care