The What, When, and Where of Hand InjuriesIn this article, Dr. Paul W. Brown, the author of the text The Hand: Primary Care of Common Problems reviews common hand injuries. He presents the what, when, and where of management for tendon and nerve injuries. Wounds, fractures, and ligament tears are also discussed.
Most hand injuries can be grouped according to severity: minor, moderate, and complex. Most minor and moderate injuries can be treated in the doctor's office. More complex problems requiring X-rays and/or surgery must be seen in the emergency department.
Dr. Brown points out that knowing the what of an injury is important. For example, what happened and what kind of force was involved in the injury? Special tests are provided to help the physician identify specific finger tendon injuries.
Asking when it happened helps establish a time line. Management of an old injury is different from the treatment for something that just happened.
And finally, knowing where the injury occurred may help direct treatment. A household wound is very different from one that occurred in a barnyard or at an industrial site.
Some injuries don't look serious but really are. The hand may look normal even with ruptured tendons, fractures, and cut arteries. X-rays first and then a careful exam help guide the examiner.
Management of minor injuries such as bruises, contusions, and mild sprains can be easily treated at home or in the office. Likewise, simple cuts, abrasions, and mild burns can be handled in the same way. More involved injuries, open wounds, deep cuts, and amputation
Paul W. Brown, MD. Pointers For Managing Common Hand Injuries. In The Journal of Musculoskeletal Medicine. August 2007. Vol. 24. No. 8. Pp. 354-359.
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