HAND INJURIES

Adapted from source

 Overview
• Common Fractures
• Infections
• Traumatic Amputations
• Glass! Can see on XR
 Fractures
• Metacarpal
– CMCJ #Dislocation
– Boxers

• Bennett’s
• Skier’s Thumb
• Trans-scaphoid perilunate #Dislocations
 Metacarpal Fractures
• CMCJ #Dislocation
• Boxers
• Trans-scaphoid perilunate #Dislocations
Base Fractures
Boxer
Peri-Lunate Dislocation
Skier’s Thumb
Skier’s Thumb
 Infections
• Septic Arthritis MCPJ
• Flexor Sheath Infections
• Others
 Clenched-Fist or ‘Fight-bite’ Injuries
A. Mixed Anaerobes and
aerobes
B. Staphylococcus aureus
C. Streptococcus
D. Eikenella corrodens
(anAerobic Gram Negative Rod)

a. Amoxicillin-clavulanate
(Augmentin) or
b. Dicloxacillin with Penicillin
(covers E. corrodens)
c. Cephalexin (Keflex) with
Penicillin or
d. Clindamycin with
Fluoroquinolone or
e. Clindamycin with
Trimethoprim-sulfamethoxazole
Flexor Sheath Infections
Crush Injuries
 High-pressure injection injuries
• Tiny entry wound, but serious
injuries
• Paint, grease and solvents
penetrate the skin and spread
throughout the underlying fascial
planes
• Need emergency decompression
and debridment of as much
foreign material as possible
• Leave wounds open,
immobilization, elevation and iv
antibiotics
Finger Amputations
Mepitel
Glass