Previous injuriesĪ history of any previous hand injury may predispose to further injury and may also mean the ‘normal’ hand for comparison is actually abnormal. A history of dislocation and reduction before presentation is important, as this may not be detected on examination. Blunt trauma causes quite different injuries to penetrating trauma. For example, a bite to the hand conveys a high risk of developing infection a history of a missed tackle (‘grabbing a jumper’) may cause a flexor tendon injury. It is important to establish what forces were applied to the hand during the injury and the direction of these forces, as well as any special features of the injury. The mechanism of injury gives important clues about the structures involved and potential complications.
The aim is not to cover each injury in detail, but to provide a framework so that the general practitioner can confidently assess hand injuries and know which injuries they can manage in their practice and which should be referred to a hand specialist.
This article provides a brief guide to the assessment of hand injuries and outlines the general principles of management for any hand injury followed by more specific detail about common injuries and their management. The causes of hand injuries are varied and include sporting accidents, occupational injuries and bites of various types.