Mutilating Hand Injuries
(Hand Trauma; Hand Injury)
A mutilating hand injury is severe damage to the hand. The injury may include damage to bones, tendons, soft tissues, nerves, and skin. It is caused by a trauma]]> . It can become a life-threatening condition.
If you have this type of injury, call 911. Untreated, this can lead to a serious infection. Immediate care will also decrease the chance of further damage.
Mutilating hand injuries can be caused by a variety of factors, including:
- Industrial accidents
- Machine injuries
- Power tool injuries
- Crushing accident
- Chemical exposure
- Car accident
- Farming injuries
This type of hand injury is the result of an accident. There are no known risk factors that increase your chance of this injury.
This injury is obvious. Bone, tendons, skin, nerves, and soft tissue may all be damaged. Common symptoms include:
- Excessive bleeding
- Amputation of hand or fingers
- Ripped skin
- Open wound
- Skin loss
- Exposed bone or tendons
Severe Hand Trauma
When you are brought to the emergency room a doctor will quickly assess your injury. Your wound will be inspected and your hand’s nerves and tendons tested. You will be asked to explain how the injury happened. You will also be asked which of your hands is dominant.
Tests may include the following:
- X-rays]]> —test that uses radiation to form an image; used to assess damage to the hand bones
- ]]>CT scan]]> —a type of x-ray that uses a computer to form an image; used to assess damage to the hand bones
- ]]>MRI scan]]> —test that uses magnetic waves to form an image; used to assess damage to the hand bones and nerves
Examination of injury under anesthesia
- Anesthesia is given so the doctor can closely examine your wound
- Debris or dirt will be removed
Immediate treatment is focused on stopping any bleeding. The doctor will make sure your vital signs are stable. An intravenous line will be started to give you fluids and medicines. You may be referred to a hand specialist for surgery. Depending on your injury, you may receive the following treatment:
This will protect you from a tetanus infection.
The following types of medication may be given:
- Pain medications
- Anesthesia to examine wound closely
- Antibiotics to prevent a wound infection
Sterile saline is used to clean the wound. This will help to prevent infection and further injury.
You may need to have immediate surgery. If your injury is less severe, your hand will be dressed and splinted. You will have a follow-up visit with a hand surgeon.
The type of surgery necessary depends upon the injury. Examples include fusing damaged joints and reattaching fingers. Often several surgeries are necessary for this type of injury.
You will likely need physical therapy to regain strength and movement in your hand. You may also work with an occupational therapist to learn how to function with your injured hand.
of Orthopaedic Surgeons
American Society for Surgery of the Hands
Canadian Orthopaedic Foundation
The Canadian Society of Plastic Surgeons
Common Hand Conditions. American Society for Surgery of the Hands website. Available at: http://www.assh.org/AM/Template.cfm?Section=Hand_Conditions . Accessed November 6, 2008.
Fingertips Injuries/Amputations. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00014&return_link=0 . Accessed November 6, 2008.
Lawnmower and Snowblower Injuries. American Society for Surgery of the Hands website. Available at: http://www.assh.org/Content/NavigationMenu/PatientsPublic/HandConditions/LawnmowerSnowblowerInjuries/Lawnmower_Injuries.htm . Accessed November 6, 2008.
Neumeister MW, Brown RE. Mutilating hand injuries: principles and management. Hand Clinics . 2003;19:1-15.
Taking care of your hand, wrist and elbow. American Physical Therapy Association website. Available at: http://www.apta.org/AM/Template.cfm?Section=Home&CONTENTID=20403&TEMPLATE=/CM/HTMLDisplay.cfm . Accessed November 6, 2008.
Tintinalli JE, Kelen GD, Stapczynski JS. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide . 6th Ed. United States: The McGraw-Hill Companies; 2004; Chapter 268, Injuries to the Hand and Digits.
Last reviewed December 2008 by ]]>Marcin Chwistek, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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