Hand and Wrist Injuries
Following a hand injury, many structures within the hand may be injured. These structures include the skin, ligaments, tendons, bones, nerves and blood vessels. It may be difficult to assess which, if any, of these structures are injured and the significance of the injuries. Should the injury be significant, or if in doubt, it is important to have an appropriate qualified medical practitioner assess your injury and direct treatment where required.
Structures that can be injured
Some small skin injuries may heal with nil or minimal treatment. Major skin injuries may require suturing or reconstructive procedures including the use of skin grafts or flaps. Wounds will often require washing out to reduce the risk of infection.
Some minor ligament injuries require no treatment and will recover spontaneously. Others may need hand therapy to regain motion or a splint to assist healing of the ligament injury. Some ligament injuries will require surgical repair or reconstruction.
The majority of tendon injuries will require surgical repair, careful splinting and hand therapy to reach maximum recovery following the injury. If mindful care is not undertaken, then stiffness, tendon rupture or lack of function may be the result.
Hand fractures can more often be treated with taping, splinting or plaster casts. This may require expert application and monitoring of progress. Some hand fractures will require operative treatment. It is important that hand fractures are assessed and treated by an appropriate qualified medical practitioner and therapist.
Nerves in the hand are often injured after wounds in the area have occurred. Should nerve injury be suspected or possible, wounds will require surgical exploration and the nerves repaired. Once repaired, nerves will not function immediately and will take months to years to regain maximal recovery. In addition, injured nerves never fully recover, with the amount of recovery dependent upon factors, including the type of injury and your age (nerves recover more fully in younger people).
Blood vessels may be injured in the hand causing bleeding and sometimes pressure effects in the hand. Significant blood vessel injury often requires surgical exploration and repair. The repair of blood vessels can cause clotting, therefore, some patients will need to be monitored in hospital for some days postoperatively, and others may require further surgery in the event of any problems.
Hand Injury Treatment Options
The treatment of hand injuries must be individualised to each patient and each injury. X-rays and other investigations may be required before commencing treatment. Treatment may not be necessary, or treatment may consist of a splint or plaster casts or an operation(s). The full extent of the injury will often not be apparent until the time of surgery.
Mr Jarrett will advise on the options available to you and the relative advantages and disadvantages (including significant risks) of each treatment to help you decide upon the correct approach for your hand. You will often require medications following your injury for pain relief, and sometimes antibiotics.
Hand Injury Postoperative Recovery
In significant hand injuries, operations may sometimes be extensive with considerable therapy and aftercare required; often further surgery is needed to treat the injury.
Following the majority of hand injuries, and unless advised otherwise, it is best to keep the hand elevated in a sling during the day and on pillows during the night to reduce swelling and pain and decrease stiffness, which will ultimately provide an improved result. Despite good medical treatment, hand therapy and dedication from the patient, more particularly in more severe injuries, the degree of recovery can be unpredictable.
Follow up appointments and hand therapy sessions are usually required.