Hand trauma

Introduction to hand trauma The hand is most exposed to the outside world and is most vulnerable to injury. According to different standards, hand injuries can be divided into many different categories. For ordinary people, it is only necessary to divide hand injuries into two categories: open injury and closed injury. Open injury: Open injury refers to hand injury with skin damage. Closed injury: For closed injury, most patients tend to ignore their severity. In orthopaedic emergency patients, hand injuries account for about a quarter of the number of visits, while open hand injuries account for two-thirds of total hand injuries. Open hand trauma early thorough debridement, try to close the wound in the next phase without tension. There are tension wounds in the first stage of skin graft or flap transplantation. basic knowledge The proportion of illness: 0.04% Susceptible people: no special people Mode of infection: non-infectious Complications: swelling, traumatic arthritis

Cause of hand injury

1, such as nails, needles, bamboo tips, wood chips, small slides and other stab wounds. It is characterized by small imports and deep damage, which can damage deep tissues and can carry dirt into deep tissues, resulting in foreign bodies retention and tendon sheath or deep tissue infection.

2. Cuts, knives, glass, cans, etc. in daily life, paper cutters and chainsaws in labor, wounds are generally neat, pollution is light, wounds are more bleeding, wounds vary in depth, and tissue damage is caused. The degree is also different. Often caused by important deep tissue such as nerves, tendons, blood vessels cut off, severe cases lead to fingertip defects, broken fingers or broken limbs.

3, blunt trauma caused by tissue contusion, can cause skin laceration, severe cases can lead to skin avulsion, tendon, nerve injury and fracture, heavy body bruises, can cause serious damage to various tissues of the fingers or hands, high speed Rotating blades, such as turbines, electric fans, etc., often cause broken limbs and broken fingers.

4, door and window extrusion can only cause fingertip injury, such as hemorrhage, nail bed rupture, distal phalanx fracture, etc., wheel, machine roller extrusion, can cause extensive skin avulsion and even fore skin degloving Multiple open fractures and joint dislocations, as well as severe destruction of deep tissues, sometimes requiring amputation of fingers and full-handed lesions.

5, such as firecrackers, detonator blast injury and high-speed shrapnel injuries, especially blast injuries, the wound is extremely neat. A wide range of injuries often lead to large areas of skin and soft tissue defects and multiple comminuted fractures. This damage is serious, necrotic and more susceptible to infection.

Hand injury prevention

1. In daily life, protect yourself and avoid trauma.

Hand trauma complications Complications, swelling, traumatic arthritis

Hand trauma can occur in patients with hand injury. In severe cases, it can manifest as massive bleeding and affect blood circulation, resulting in swelling of the affected limb. Patients who do not pay attention to early exercise after surgery may have tendon and joint adhesions, which may cause dysfunction. In severe cases, joint stiffness and traumatic arthritis may occur. In addition, the most common complication of open hand trauma is infection, the main reasons include: mechanical strains, crushing damage caused by tissue collapse, inactivation of the organization is not clear, debridement is not complete.

Symptoms of hand injury Common symptoms Finger sprained finger hitting the palm of the hand Hard edema Palm softness and abnormality Fingers can not bend and stretch the hand grip weakness of the wrist swelling and palm flexion... Hand skin purple finger joint pain swelling middle finger unexplained pain

Clinical manifestations of hand trauma

1. Open hand injuries include stab wounds, cuts, lacerations, crush injuries, blast injuries and burns. May cause damage, defects, and dysfunction or loss.

2. The flexor injury of the hand is a straight deformity and flexion dysfunction. The extensor injury of the hand is a flexion deformity, a straightening disorder, a central bundle break of the extensor muscle, a "button"-like deformity of the proximal interphalangeal joint, a lateral bundle combined with a sacral fracture, and a distal finger joint with a hammer-like deformity.

3. The nerve damage of the hand, the loss of sensation in the dominating area and the loss of active movement can be deformed by the wrist, the hand or the claw-like hand, respectively.

4. Vascular injury to the hand can cause reflux obstruction, or ischemic necrosis, or Vokkmann muscle contracture.

5. Hand bone and joint injuries can cause pain, swelling, various deformities and abnormal activities due to fracture and dislocation.

Hand injury examination

Hand injury inspection includes the following aspects

Hand injury involves nerves, muscles, and blood vessels. Corresponding examinations are needed. Heparin in patients with replanted fingers is sometimes required to detect prothrombin time, fibrinogen, etc., and blood physicochemical determination and blood gas analysis are affected.

Skin damage examination

(1) Understand the location and nature of the wound; (2) Estimation of skin defects; (3) Judgment of skin vitality : a, skin color and temperature; b, capillary reflux test; c, shape and size of the flap; d, the length to width ratio of the flap; e, the direction of the flap; f, bleeding at the edge of the skin.

Examination of tendon injury

Nerve injury examination

Vascular injury examination

Examination of bone and joint injuries

Diagnosis of hand injury

Diagnose based on

1. Have a history of open or closed trauma.

2. Have one or more of the above symptoms and signs.

3. X-ray film shows bone and joint damage.

4. EMG, Doppkes examination, Akkes test can detect neuromuscular, vascular damage.

Differential diagnosis

1. Open injury: Open injury refers to hand trauma with skin damage.

Second, closed injury: for closed injury, most patients easily overlook its severity.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.