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Hand injuries are among the most frequent musculoskeletal problems encountered in clinical practice. They can involve the bones, joints, tendons, ligaments, nerves, vessels, or skin, with severity ranging from minor lacerations to complex fractures and soft-tissue damage. Early recognition of the injury type, associated symptoms, and appropriate treatment is crucial to preserve hand function and prevent long-term complications.
Types of Hand Injuries
Hand injuries are a wide group of problems that can affect the skin, bones, tendons, nerves, and blood vessels. These injuries can happen suddenly from an accident or over time from repeated actions. Here are some of the common types of hand injuries and the parts of the hand they affect.
1. Tendon injuries
Tendons are strong cords that connect muscles to bones, allowing for movement. Tendon injuries often happen from deep cuts. There are two main types: flexor tendon injuries affect the tendons on the palm side that bend the fingers, and extensor tendon injuries affect the tendons on the back of the hand that straighten the fingers. If a serious tendon injury is not treated, it can lead to a lasting loss of function.
2. Nerve injuries
Nerves are like the wires of the body. They send messages from the brain to the muscles and carry feelings back to the brain. Nerve injuries can happen from deep cuts, crushing, or constant pressure. Symptoms can include numbness, tingling, or muscle weakness in the affected area. The healing process for a nerve injury is often slow, and sensations may not fully return to normal.
3. Crush Injuries
Crush injuries are severe problems that happen when the hand is squeezed or crushed between two heavy objects. These injuries can damage many parts at the same time, including the skin, muscles, tendons, nerves, and bones. Crush injuries often require immediate and extensive medical care to save the hand and help it work again.
4. Sprains & Strains
A sprain is an injury to a ligament, which is the tough tissue connecting bones at a joint. A strain is an injury to a muscle or a tendon. Sprains and strains in the hand typically result from a sudden twist or a hit, such as from a fall or a sports accident. While often less severe than a fracture, they can still cause significant pain, swelling, and stiffness that takes time to heal.
5. Burns
Hand burns may result from exposure to heat, flames, chemicals, or electrical currents. Their severity can range from superficial injuries to deep tissue damage. Prompt first aid is essential to minimize complications, while many cases require specialized medical attention to promote proper healing and reduce the risk of scarring that may impair hand function.
Symptoms of Hand Injuries
- Pain: Can range from a mild ache to severe, sharp pain, especially when trying to move the injured part.
- Swelling and bruising: The area around the injury gets puffy and may turn color.
- Deformity: The hand or finger looks bent or out of place, which can mean a broken bone or a joint out of place.
- Numbness or tingling: A sign that a nerve might be injured.
- Difficulty gripping: Weakness or pain when trying to hold objects.
- Limited or no movement: The inability to move a finger or the hand, which may point to a tendon, nerve, or joint injury.
How to Treat Hand Injuries
- Initial First Aid: For minor injuries, clean the wound and cover it with a sterile bandage. For more serious injuries, raise the hand to reduce swelling and apply ice (wrapped in a cloth) to the injured area.
- Immobilization: Use a splint or cast to prevent the hand or finger from moving. This helps fractures, sprains, or tendon injuries heal properly.
- Medication: Pain relievers can help manage pain and swelling. For an infection, a doctor may prescribe antibiotics.
- Physical and Occupational Therapy: These are important for getting strength, movement, and function back after an injury has healed.
- Surgical Repair: Surgery may be necessary for severe injuries like badly broken bones, cut tendons, or damaged nerves that cannot be treated otherwise. The surgical technique chosen depends on the severity and type of injury.
- Minimally Invasive Surgery (e.g., Arthroscopy): This advanced technique uses small “keyhole” incisions. A tiny camera (arthroscope) and specialized instruments are inserted to visualize and repair structures, particularly within the wrist joint, without requiring a large opening. This approach provides precise diagnosis and treatment for joint-related issues with less pain, minimal scarring, and a faster recovery.
- Open Surgery: This approach involves a larger, carefully placed incision to gain direct visibility and access to complex, deeper structures. It is essential for severe or complicated procedures that require absolute precision, such as:
- Fracture Treatment: Using open reduction to realign severely fractured bones and then using fixation techniques, often with implants like plates and screws, to stabilize the bone during the healing process.
- Tendon and Nerve Repair: Directly reattaching severed nerves or tendons (Primary Repair), or performing more complex Secondary Repairs that may involve using a nerve or tendon graft (inserting tissue from other areas of the body).
- Joint Replacement (Arthroplasty): Precisely replacing a joint destroyed by severe arthritis with an artificial joint made of materials like pyro carbon, titanium, or the patient’s own tissue.
How to Prevent Hand Injuries
- Use Safety Gear: Always wear gloves and use guards when operating saws or other machinery.
- Pay Attention: Stay focused when working with sharp tools or doing tasks that need your full attention..
- Get Tetanus Shots: Keep your tetanus immunization up to date to protect against infections from cuts.
When to See a Doctor
It is important to seek medical help immediately if your hand injury has any of these symptoms: severe swelling, bleeding that won’t stop, a visible deformity, numbness, cold fingers, or the inability to move your hand or fingers.
If a deep cut shows bone or tendons, you should go to the emergency room right away. For a sports injury, if the hand injury does not get better after a week or two, or if you continue to feel pain, you should see a hand specialist. Getting the right care quickly is the best way to heal completely and avoid long-term problems.
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