[The treatment of combined digital-palmar injuries]

Different treatment modalities for palmar combined injuries of the fingers are described. Several possibilities are mentioned for each traumatized structure which can be involved in such injuries. Early functional after-treatment is emphasized, which usually needs stable reconstruction for all injured components (skin, nerves, arteries, fractures, joints, flexor tendons and pulleys), so as to allow immediate active mobilization. The results of palmar combined injuries of 178 fingers in 150 patients, treated from September 1986 to May 1991 at the Division of Hand Surgery, University of Bern, Switzerland, offer the more recent experience for the favoured handling of such injuries. The results were collected and statistically analyzed to seek for mutual interactions in the healing of the different structural components.