Hand and Finger Injuries: Tendon and Soft Tissue Injuries of the Hand

Patients with any laceration or wound over the hand need to be evaluated for tendon and neurovascular injuries. Patients with these injuries should receive urgent wound care as well as splinting and expeditious referral for surgical repair because lacerated tendons and nerves cannot heal without surgical approximation. Conversely, ligament injuries of the hand, such as disruption of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb, can sometimes be managed nonsurgically if the joint is stable and there is no Stener lesion. If nonsurgical management does not stabilize the joint, patients should be referred for surgery. Stener lesions, where the ulnar collateral ligament at the metacarpophalangeal joint of the thumb has torn and retracted proximal to the adductor pollicis, always require surgery for the ligament to heal and for the best outcomes; however, surgery is not urgent.