GENERAL OPEN HAND INJURIES

Open Injuries Conditions Open Hand Injuries General Open Hand Injuries

Flexor Tendon Injuries Nerve Related Injuries  General Open Hand Injuries

Open hand injuries refer to any injury that penetrates the skin of the hand, whether it's in the palm or the back of the hand and where the subcutaneous fat is exposed. These injuries can be as minor as a small cut created by trying to remove an avocado pip with a sharp knife or could be catastrophic like an industrial or farming accident where there is a large injury zone affecting the skin, muscles, and tendons, as well as the bone and joints. Whether the injury is small or big, our approach is generally the same.

Treatment

The principle is to make sure that the wound is properly cleaned and washed out, as once there is an open injury, there is a risk of bacterial seeding and secondary bacterial infection. It is then preferable to operate, undertaking a surgical debridement and then an exploration of the wound to ascertain whether there are deeper injuries to the anatomical structures. The anatomy of the hand is very delicate, and most of the structures lie just below the skin surface, so all injuries, big or small, are treated seriously.   

The wound is surgically debrided, and all excess dirt is removed and washed out.   A surgical exploration is done of all the involved anatomical structures. The skin will be open slightly, and any structural damage to the nerve, arterial blood supply, tendons, and all the ligaments will be repaired at the same time. These injuries are commonly associated with fractures of the hand, and this is usually internally fixated with a plate and screws to ensure a solid fixation and facilitate mobilizing the hand as early as possible. Whenever a wound penetrates the joint, especially around the knuckles, there is a high risk of infection, and a washout is imperative.

Treating hand wounds requires the care of a specialist who has the expertise to suture these wounds in a specific way that allows post-operative movement. In the acute phase, all fingers are immobilized to facilitate healing for the first few days, and then a very purposeful rehabilitation plan is undertaken as soon as possible to start mobilization of the hand.

A sub-section of open injuries pertains to bites, whether it is animal or human bites. These we also treat very seriously, as typically animal bites, like cat bites, have very small but deep penetrations and cause bacterial seeding. It is, therefore, imperative that these wounds are treated urgently with surgical debridement and intravenous antibiotics.

FAQ

1What types of hand injuries occur?
Common hand injuries include bruises, damage to ligaments (skier’s thumb), mallet finger, joint and muscle sprains, fractures, dislocations and crushing injuries.
2How do you treat an open hand fracture?
Surgery is required to treat an open hand fracture. Firstly, the surgeon debrides the wound and then proceeds to an open reduction to reduce the fracture fragments and stabilize the fracture with plates or pins
3What are the signs a hand injury is serious?

You should watch out for the following warning signs of a hand injury:

  • Excessive bleeding
  • A numb sensation in the hand
  • Loss of hand mobility
  • Hand pain
  • Hand deformity
  • Redness or swelling over the hand

Please read the above text for more in-depth information to help answer these questions. It's important to consult with our qualified healthcare professionals to ensure the appropriate diagnosis and treatment plan for your specific situation.