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[Complex trauma of the hand]

S Pechlaner1, H Hussl

  • 1Universitätskliniken Innsbruck.

Der Orthopade
|April 16, 1998
PubMed
Summary
This summary is machine-generated.

Severe hand injuries require immediate, comprehensive repair focusing on bone, soft tissue, and neurovascular structures. Optimal functional outcomes depend on specialized surgical centers for complex hand trauma.

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Area of Science:

  • Orthopedics
  • Microsurgery
  • Trauma Surgery

Background:

  • Hand injuries are common in daily work, often resulting in poor functional outcomes due to damage to soft tissues, bones, and vital structures.
  • Complex hand injuries, frequently caused by crush trauma or rotating saws, compromise hand vitality, sensibility, and motor function.

Purpose of the Study:

  • To outline a comprehensive approach for the extended primary repair of severe and complex hand injuries.
  • To detail the reconstructive strategies for various damaged hand structures, including bone, tendons, vessels, and nerves.

Main Methods:

  • Radical debridement followed by staged reconstruction: osteosynthesis and joint stabilization, tendon repair, and microsurgical neurovascular reconstruction.
  • Use of pedicled or free flaps for covering exposed defects, with a modified approach prioritizing vascular reconstruction in cases of prolonged ischemia.

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  • Systematic evaluation of functional outcomes, focusing on the restoration of vitality and sensibility.

    • Main Results:

    • Detailed results on the restoration of hand vitality and sensibility after complex injury repair are presented.
    • The importance of each individual functional restoration in achieving overall success for complex hand injuries is highlighted.

    Conclusions:

    • Extended primary repair is recommended for severe hand injuries after radical debridement.
    • Successful treatment of complex hand injuries necessitates a multidisciplinary approach and should be performed at specialized hand surgery centers.