Hand trauma refers to injury involving the fingers, hands and wrists, including the tendons, ligaments and nerves.
From simple fingertip injuries to tendon injuries and fractures, hand injuries can be divided into these general categories:
Burns. Burn injuries to the hand caused by heat, chemical or electrical sources can damage skin, nerves and blood vessels. First-degree burns such as sunburn cause redness and localised pain, while second-degree burns cause blisters and peeling of the skin, and swelling. Third-degree burns refer to skin that has been charred, with nerve damage.
Lacerations. Lacerations, or deep cut or tearing of your skin may be caused by injury from a sharp object. Unlike an abrasion, there is no loss of skin. It is usually treated by cleaning and dressing the cut to prevent infection and allow healing. Severe or deep cuts may require stitches.
Fractures and dislocations. Fractures and dislocations involve injury to the bones and joints. A fracture refers to a partial or complete break in a bone, while a dislocation is when 2 connected bones are separated.
High pressure injection injuries. High pressure injection injuries commonly occur on the dominant hand and index finger from high-pressured devices such as grease and paint guns or diesel fuel injectors. It may appear as a small sore on a finger, but can be severe depending on the level of pressure, its quantity and temperature.
Infections. Infections can usually be treated with antibiotics in its early stages. If left untreated, the infected tissues will need to be removed and the wound drained of pus. A severe infection may have long-lasting consequences such as damage to the tissues, nerve and bone.
Soft tissue injuries (STI). A soft tissue (flesh) injury can affect the muscles, ligaments and tendons. STI can be classified as contusions or bruises, sprains, tendonitis, bursitis, strains and stress injuries.
Amputations. An amputation refers to the loss or removal of a limb, usually as a result of injury (trauma) or disease.
What are the symptoms of hand trauma?
Symptoms of hand trauma vary depending on the type of injury, how it occurred, its depth, its severity and its location. These include:
Burns. Tenderness or complete numbness, deformity (with or without tissue loss), discolouration, loss of tissue, change in skin texture, redness, blistering, and black areas of tissue.
Fractures and dislocations. Tenderness, deformity, swelling and discolouration, decreased range of motion (difficulty moving), numbness, weakness and bleeding.
High pressure injuries. Pain, swelling, and occasional skin discolouration.
Infections. Tenderness, localised warmth, redness, swelling, fever (rare), deformity, and decreased range of motion.
Lacerations. Tenderness, bleeding, numbness, decreased range of motion, weakness, and pallor (pale or bloodless appearance).
Soft tissue (flesh) injuries and amputations. Tenderness, deformity (with or without tissue and bone loss), swelling and discolouration, bleeding, weakness, and numbness.
What are the causes of hand trauma?
Hand trauma and injuries are usually caused by accidents or a result of repetitive use. These include:
Impact during recreational activities or sports. These can range from a simple sprained finger from a sudden twist, to knuckle fractures from a hard knock, or mallet finger from a ball hitting the tip of your fingers.
Accidents such as mishaps in the kitchen which can lead to cuts and burns, or the impact from breaking a fall with your hands.
Wear and tear from ageing or overuse, which could lead to arthritis as well as strains and sprains from heavy lifting or poor technique.
Use of certain tools, equipment or heavy machinery involving high pressure, extreme temperatures or moving parts.
What are the risk factors for hand trauma?
The risk of finger, hand or wrist injury is higher in contact sports, such as wrestling, football, and in high-speed sports, such as biking and skateboarding. Sports that use hand equipment such as hockey sticks or racquets also increase the risk of injury.
In children, most finger, hand or wrist injuries occur during sports, play or from accidental falls. Older adults are at higher risk for injuries and fractures because they lose muscle mass and bone strength as they age. They also have more problems with vision and balance, which increases their risk of accidental injury.
Hand injuries can happen to anyone, at any time and when you least expect it. You can reduce your risk and help prevent injuries by being careful.
What are the complications and related diseases of hand trauma?
Hand trauma and injuries can lead to lasting damage if treatment is delayed or neglected.
Bone deformities (malunions). A broken hand can heal by itself. But without proper treatment, the bones might not line up properly and are more likely to heal incorrectly. This condition is known as a malunion and it can lead to impairment of hand function.
Delayed union and nonunion fractures. A fracture that takes longer to heal than usual is called a delayed union. A nonunion fracture is a fracture that has no potential to heal without medical intervention such as surgery.
Bone infection (osteomyelitis). Infections can occur when bacteria enter the body during a trauma. Less commonly, infections can happen during a bone surgery.
Nerve or blood vessel damage. Trauma to the hand can injure adjacent nerves and blood vessels. Seek immediate attention if you have numbness or circulation problems.
Osteoarthritis. Bone fractures that extend into a joint can cause arthritis years later. If your hand starts to hurt or swell long after an injury, see a hand specialist to get an assessment.
How do you prevent hand trauma?
You can reduce your risk and help prevent injuries by being careful. Here are several things you can do:
Being attentive while working or performing daily tasks.
Using the correct technique while cutting, gripping and lifting.
Taking regular breaks to relieve pressure on your hands.
Using protective gear while playing sports or using heavy equipment, including gloves and wrist guards.
Stretching and warming up before playing sports can help prevent injuries.