Acute management for the injured hand

If not optimally treated, a hand injury can lead to disability which often has considerable economic and social implications. The role of the primary care physician is to diagnose the injury correctly and initiate management which will keep this disability to a minimum. This is best achieved by making a composite diagnosis to include all the injured components of the hand. The emphasis must be on early mobilization of the injured area and the maintenance of mobility in all joints of the upper limb. Early referral to physiotherapy and occupational therapy departments is highly desirable. The major pitfall in managing hand injuries is over zealous treatment of the fracture at the expense of the soft tissue injury, resulting in iatrogenic stiffness.