MANUAL MINORS
Hand injuries can affect a wide range of structures, including bones, tendons, nerves, ligaments, and blood vessels. The clinical signs of a hand injury vary depending on the type and severity of the injury but generally include pain, swelling, deformity, and loss of function. Prompt identification of these signs is essential to prevent long-term complications such as loss of mobility or strength.
Diagnosis
Clinical Sign | Description |
Localized Pain | Usually in the affected area, ranging from mild to severe in intensity. |
Swelling | Swelling around the injured area, indicating inflammation or fluid accumulation. |
Visible Deformity | Deviation of the fingers or wrist, suggesting fractures or dislocations. |
Limited Movement | Difficulty or inability to move the fingers or wrist, indicative of tendon injuries, fractures, or dislocations. |
Bruising | Reddish or bluish skin discoloration, indicating underlying vascular trauma. |
Loss of Sensation | Suggestive of nerve injuries, especially involving the median, radial, or ulnar nerves. |
Crepitus | A cracking or popping sensation with joint movement, common in fractures or joint injuries. |
Differential Diagnosis
Injury | Distinctive Features |
|---|---|
Fracture | Acute pain, visible deformity, bone crepitus, severe movement limitation, significant bruising or swelling. |
Tendon rupture | Inability to actively move a finger or wrist (flexion or extension), pain, no visible bone deformity. |
Nerve injury | Loss of sensation in specific areas (e.g., thumb and index-middle fingers in carpal tunnel syndrome). |
Joint dislocation | Obvious deformity in the affected joint, severe pain, inability to move the finger or wrist. |
Tenosynovitis | Pain and swelling along the tendon, difficulty moving the affected finger, snapping or locking movement. |
Emergency Management
In emergency settings, initial management of hand injuries involves immobilisation, ice, and analgesia for pain control. Fractures, dislocations, and tendon ruptures require immediate specialist evaluation. Open wounds should be cleaned and sutured if necessary, with antibiotic prophylaxis if infection risk exists. If vascular or nerve damage is suspected, urgent neurovascular assessment is required.
Definitive Treatment
Definitive treatment depends on the type of injury. Fractures may require closed reduction or surgery for stabilisation, while tendon and nerve injuries generally need surgical repair. Post-injury physiotherapy is crucial for restoring hand mobility and function. Minor injuries, such as sprains or tenosynovitis, are treated conservatively with temporary immobilisation, NSAIDs, and physical therapy.
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