Hand Injuries

Hand injuries can be minor or complexed and major in nature. Sometimes it is difficult for the patient to discern the severity of the injury.

Minor Injuries

Figure B: 1 year after the successful surgery

The injury shown in Figure A may seem serious. But this fingertip injury can easily be attached back in place by a qualified hand Surgeon. The nail bed is protected by an artificial nail splint to allow proper healing of the nail bed.

Major Hand Injuries

What you see in Figure B may seem like a simple cut, but it is in fact a deep stab laceration to the right palm.

Due to the site and depth of injury, the ulnar nerve is injured and results in paralysis of the intrinsic muscles to the hand. This also resulted in the loss of sensation to the ring and little fingers.

Immediate treatment should be sought to ensure the nerve is repaired with the aid of the microscope. A delayed repair may result in the need for nerve graft and poorer outcome.

Figure C: Exploration showed the ulnar nerve and artery transected. This needs microsurgical intervention.

Figure D: Ulnar artery and the 2 branches of the ulnar nerve repaired with the aid of the microscope.

Tendons are like cables that help you bend and straighten your fingers. However, the muscles which move your fingers are located up in your forearm, but it is the tendon that connects the joints of the fingers to the muscles. The most common and difficult problem that people have after a tendon injury is the loss of the ability to fully bend or straighten the finger.

In this case, surgery can be done to repair or graft the tendon depending on the timing of surgery. Acute injuries require repair while late diagnosis may result in the need for grafting.

This is the result of missed tendon injuries to the right middle and ring finger.

Figure E: Pre-operative absence of flexion to the middle and ring fingers.

Figure F: Operative findings showing loss of the flexor tendons.

Figure G: Harvesting of the palmaris longus tendon graft.

Figure H: Grafting of the flexor tendons to the middle and ring fingers.

Figure I: Post operative results after 6 months.

Figure J: Acute flexor tendon injuries such as this require only a good flexor tendon repair and hand therapy.

Figure K: Therapy and post-operative results of a 3 finger flexor tendon injuries.

Fracture of the hand can be very common. This usually presents with pain and swelling. There will be a bruise and the pain does not usually go away after the injury. There maybe deformities, by then it will be obvious to the patient.It is usually the intra-articular fractures that requires immediate or early attention but these fracture are usually missed because it has very little deformity and brusing. Stable fractures can be treated conservatively unstable and intra-articular fractures including comminuted fracture, open reduction and internal fixation gives the best results.

Figure L: Proximal phalangeal fracture with open reduction and internal fixation done.