Hand injuries
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Hand injuries. Priorities. Function, Function, Function! Must be able to test sensory, motor and tendon function. Should be able to draw a cross-section of wrist. If tendon, nerve or vascular injury, consult . Know the location of all important deep structures. Priorities.

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Presentation Transcript

Priorities l.jpg
Priorities

  • Function, Function, Function!

  • Must be able to test sensory, motor and tendon function. Should be able to draw a cross-section of wrist. If tendon, nerve or vascular injury, consult.



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Priorities

  • Adequate coverage of important structures

  • Consider if simple repair of laceratons crossing joint will lead to limiting contracture

  • Must know proper bandaging and splinting



Why a fight bite even seen early needs exploration hidden tendon injury and joint violation l.jpg
Why a “fight bite”, even seen early needs exploration. Hidden tendon injury and joint violation


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Anatomy of finger nail Hidden tendon injury and joint violation




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Use cleaned whole nail as dressing, base under cuticle to prevent nail matrix to eponychium adhesion. If nail not possible, adaptic or foil from suture package


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After nail removal prevent nail matrix to eponychium adhesion. If nail not possible, adaptic or foil from suture package

  • Irrigate open wound carefully, remove foreign material,

  • Debride conservatively if at all, very little excess tissue for repair

  • Close nail bed laceration with 6-0 absorbable (eccentric hand guys would use 8-0 and loops, If you try this you will need very fine instruments, such as castro-viejo driver and tying forceps)


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