hand injuries

Hand injuries

Splintage of the hand Three positions of the hand:
(a) The position of relaxation, (b) the position of function
(ready for action) and (c) the position of safe
immobilization, with the ligaments taut.

METACARPAL FRACTURES

FRACTURE OF THE THUMB METACARPAL
Bennett’s fracture-dislocation

FRACTURES OF THE PHALANGES

These
can be treated, depending on the
‘personality’ of the fracture,
experience of the surgeon and
equipment available, with neighbour
strapping (a), plate fixation
(b), percutaneous screw fixation (c) or
percutaneous wires (d).


A fracture of the tuft (a),
caused by a hammer blow, is treated by a protective
dressing. The subungual haematoma should be evacuated
using a red-hot paper clip tip

Mallet finger injury

A mallet
finger (c) is best treated with a splint for 6 weeks (d).
Mallet fractures (e) are also better splinted – surgery can
make the outcome worse.

JOINT INJURIES

Finger
dislocation (a)
Metacarpo-phalangeal
dislocation in the
thumb occasionally
buttonholes and needs
open reduction; (b,c)
interphalangeal
dislocations are easily
reduced (and easily
missed if not x-rayed!).


Ten. injuries
Testing the flexor tendons Testing for (a) flexor
digitorum profundus (FDP) lesser fingers, (b) flexor
digitorum superficialis (FDS) lesser fingers, (c) FDP index,
(d) FDS index.