Introduction
Anatomy of the Hand and Wrist
Hand Examination
Hand Imaging
Trauma
Special Considerations
Amputations and Replantation
Care of an amputated part
- Gentle removal (eg, saline irrigaiton) of gross contamination (eg, sawdust, debris)
- Wrapped in sterile saline-moistened gauze and sealed in a plastic bag.
- To avoid desiccation
- The bag should be then placed in a container of ice water to be transported with the patient.
- Cooling decreases tissue metabolism anda oxygen demand.
- An ice water bath (~0?) provides adequate cooling while minimizing the risk of frostbite
Fingertip injuries
High-Pressure Infection Injuries
Compartment Syndromes
Complications
Nerve Compression
Degenerative Joint Disease
Dupuytren’s Contracture
Risk factors
Male sex, age >50, family history, Northern European ancestry.
DM, tobacco & alcohol use
Manual work (eg, gardening)
Clinical presentation
Thickening of palmar fascia at the 3rd, 4th & 5th digits
Discrete nodules along flexor tendons near distal palmar crease
Decrease extension of digits
Treatment
Modification of hand tools (eg, cushion tape, padded gloves)
Needle aponeurotomy
Intralesional glucocorticoid injection
Surgery for contractures or advanced disease
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