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Mutilating Hand Injuries

(Hand Trauma; Hand Injury)

Definition

A mutilating hand injury is severe damage to the hand. The injury may include damage to bones, tendons, soft tissues, nerves, and skin. It can become a life-threatening condition.

If you have this type of injury, call for medical help right away. Immediate care may result in a better repair and decrease the chance of further damage. Untreated, this can lead to a serious infection.

Causes    TOP

Mutilating hand injuries can be caused by a variety of factors, including:

  • Industrial accidents
    • Machine injuries
    • Power tool injuries
  • Crushing accidents
  • Burns
  • Chemical exposure
  • Car accidents
  • Farming injuries

Risk Factors    TOP

Factors that may increase your chance of injury include:

  • Having an occupation that requires use of dangerous machinery
  • Removing safety guards from machinery, such as power saws or wood chippers
  • Using short-cuts and improper technique while using machinery
  • Using your hands to remove clogged grass from lawn mowers or snow from snow blowers without shutting off the power
  • Operating machinery or vehicles under the influence of alcohol or medications that cause impairment during use

Symptoms    TOP

Injury to the hand is obvious. Bone, tendons, skin, nerves, and soft tissue may all be damaged. Common symptoms include:

  • Excessive bleeding
  • Amputation of hand or fingers
  • Ripped skin
  • Skin loss
  • Open wound
  • Exposed bone or tendons
  • Pain

Severe Hand Trauma

hand trauma
© Nucleus Medical Media, Inc.

Diagnosis    TOP

When you are brought to the emergency room, a doctor will quickly assess your injury. Your wound will be inspected and your hand’s nerves and tendons will be tested. You will be asked to explain how the injury happened. You will also be asked which of your hands is dominant.

Imaging tests assess damage to the bones, nerves, tendons, skin, or other soft tissues. These may include:

You may need examination under anesthesia to:

  • Allow the doctor to closely examine your wound
  • Remove debris or dirt

Treatment    TOP

Immediate treatment is focused on stopping any bleeding. The doctor will make sure your vital signs are stable. An IV will be started to give you fluids and medications. You may be referred to a hand specialist for surgery. Depending on your injury, you may receive the following treatment:

Tetanus Shot

This will protect you from a tetanus infection.

Medications

The following types of medication may be given:

  • Pain medications
  • Anesthesia to examine the wound closely
  • Antibiotics to prevent a wound infection

Wound Irrigation    TOP

Sterile saline is used to clean the wound. This will help prevent infection and further injury.

Hand Surgery    TOP

Immediate surgery may be needed. If the injury is less severe, the hand will be dressed and splinted. A follow-up visit with a hand surgeon will be needed.

The type of surgery necessary depends upon the injury. Examples include fusing damaged joints and reattaching fingers. Often, several surgeries are necessary for this type of injury.

Rehabilitation     TOP

Physical therapy will be needed to regain strength and movement in your hand. Occupational therapy may also be needed to learn how to function with your injured hand.

Prevention    TOP

To help reduce your chance of a hand injury:

  • Do not operate machinery that you are unfamiliar with.
  • Follow all safety instructions when operating tools or machinery. Be especially careful when using snow blowers and lawn mowers. These commonly used tools result in many hand injuries each year.
  • Do not put fingers or hands near moving parts of machinery.

RESOURCES:

Hand Care—American Society for Surgery of the Hand
http://handcare.assh.org
OrthoInfo—American Academy of Orthopaedic Surgeons
http://www.orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Foundation
http://www.canorth.org
The Canadian Society of Plastic Surgeons
http://www.plasticsurgery.ca

References:

Fingertips injuries and amputations. American Academy of Orthopaedic Surgeons Ortho Info website. Available at:
...(Click grey area to select URL)
Updated July 2016. Accessed November 13, 2017.
Hammig B, Jones C. Injuries related to snow blowers in the United States: 2002 through 2008. Acad Emerg Med. 2010;17(5):566-569.
Kamrani RS, Mehrpour SR, Aghamirsalim MR. High-pressure plastic injection injury of the hand: case report. Occup Med (Lond). 2011;61(7):518-520.
Neumeister MW, Brown RE. Mutilating hand injuries: principles and management. Hand Clinics. 2003;19(1):1-15.
Snowblower and lawnmower injuries. American Society for Surgery of the Hand Hand Care website. Available at:
...(Click grey area to select URL)
Accessed November 13, 2017.
4/25/2014 DynaMed Plus Systematic Literature Surveillance. http://www.dynamed.com: Bruno MA, Weissman BN, Kransdorf MJ, et al. American College of Radiology (ACR) Appropriateness Criteria for acute hand and wrist trauma. Available at:
...(Click grey area to select URL)
Updated 2013. Accessed April 25, 2014.
Last reviewed November 2017 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Last Updated: 12/20/2014

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