Major Hand Cut Injury- Nerve, Artery, Tendon Repair

 

 Hand-Cut Injury and Tendon, Nerve, Artery Injury

Hand-cut injury or sharp hand laceration injury is very common in this era of machine. It present with injury at a different part of the hand and forearm. Plastic surgery plays a very important role in saving such type of hand after injury.

 

Case with a major hand injury

This patient a young man working in a factory got injury in his left hand when his left hand came in contact with the sharp blade of the machine.

 

After the injury, he had a sharp wound ion his left palm it was a deep wound. the patient was having heavy bleeding from the wound. 

 

Initially, he was taken to a nursing home where he was treated by a surgeon. Stitches were applied and the wound was repaired.

 

After the primary patient was not able to bend his ring and little finger. he was also having loss of sensation in the fingers 

 

He was brought to our Fortis Escort Hospital in Faridabad. His clinical examination revealed that the patient is having tendon and nerve injury. He was planned for surgery to repair the damaged structure of the hand.

 

Hand-Cut Wound Plastic Surgery

 

After Investigation and evaluation patient was prepared for surgery. His wound was explored and all damaged structures were identified. In his hand, Nerves which take sensation from finger to brain was found damaged. The arteries which carry blood from the heart to the finger were also severed. The tendons that are responsible for the movement of fingers at the finger joint were also found cut 

 

Plastic surgeon Dr. S.K.Chawla repaired all the damaged structures. Nerve artery and tendons were repaired. The skin wound was also closed. The plaster slab was applied to prevent the injury of repaired structures of the hand.

 

 

 

 

Hand Cut Injury Before After Plastic Surgery

 

Recovery After Hand Plastic Injury 

 

After 2 weeks, all the stitches were removed. After 3 weeks all dressing and splints were removed.

The plastic surgeon advised physiotherapy of fingers and hand after 3 weeks.  After 6-8 weeks of physiotherapy, the patient was able to move fingers.

 

Role of Plastic Surgeon in Hand Surgery 

A plastic surgeon does the reconstruction of all damaged structures. He is trained in managing soft tissue. He can manage and reconstruct structure at the microscopic level. 

Electric Burn - Early Treatment can Save Arm

Electric Burn - Early Plastic Surgical Intervention can Save Arm

Electric burn injuries are common injuries in India. Both man and women are affected by these type of injuries. In can happen in factories and in house. Children also visit very commonly in our hospital with electric burn injuries.

A Care of Electric Burn

Recently Mrs Deepa a young woman from Mathura city presented to our emergency department with electric burn injuries. She got burn injury while working at home . On examination it was found that She was having electric contact burn at base of index and middle finger and distal palm of right hand. Next day when she was re-examined her arm was very tight and hand was grossly swollen. She was developing compartment syndrome.

She was immediately taken for surgery and tight muscle compartment was released by giving a long cut in arm by plastic surgeon. Compartment release is a limb saving procedure . This must be done as early as possible. One compartment is released blood flow to the arm and forearm muscles and hand is restored
  

Right Forearm  with compartment syndrome

Forearm after compartment release

Cause of Electric Burn-

Electric burn happens whenever somebody comes in contact with electric wire or any object through which electricity is passing.
Sometime there is sparking from wires and it lead to thermal burn and it is called as electric flash burn.

Symptoms of Electric Burn -

Patients with Electric burns present with different symptoms

• Electric shock
• Electric contact burn with wounds on body . They are called as entry and exit wounds 
• Deep burn wounds 
• Gangrene of hand , Arm , leg and Thigh
• Electric spark leading to flash burn 

Cause of Death In Electric Burn -

Most common cause of death in an electric burn patient is cardiac arrythmia . In such cases when  electricity passes through body it disturb the normal heart rhythm and it is responsible for death in most of patient . those patient who survive for more than 24 hours may die due to many other complications of electric burn.

Cut Injury Of Hand By Broken Glass

Broken Glass and Hand Injury

Cut injuries of hand by broken glass are very common these days. It can be a small puncture injury or very severe injury of forearm ( below elbow) or in hand. 

Symptom and Sign of Glass injury

If anybody gets glass injury in forearm there will be-

Wound or cut in skin

Wound of variable size at the site of injury. It may be small puncture wound or large cut injury.

Severe bleeding

Patient may or may not have severe bleeding from wound of arm and hand. It depends upon the injury of artery or vein or both.

Inability to move fingers and thumb

This happens due to muscle and tendon injury . These tendons and muscles are responsible for the movement of fingers and thumb. most of the time they are completely divided . Whenever there is tendon  injury one can not move fingers . 

Loss of sensation in hand and fingers 

There are three nerves which are responsible for the sensation or sensory activity in the hand . These nerves pass from forearm to hand through wrist. Glass may cut these nerves at the site of injury. Whenever there is nerve injury person will have no sensation in fingers and hand. 

What Should You Do After The Glass Injury

Most important is to stop bleeding. Immediately one should take a clean cloth and press the area of bleeding to stop blood .You should immediately run to a good hospital where facility of plastic surgery or hand surgery is available. Plastic surgeon or a trained hand surgeon is the ideal one to manage such kind of severe glass cut injury.

It is very Important to explore the cut wound under general anaesthesia. Your hand surgeon will identify  the structures which are damaged by penetrating glass.

Bad Finger Tip Injury Repair Can Ruin Your Hand

Finger Tip Injury is one of the most common Injuries of hand . However anybody can get this type of injury but it usually happen in children, housewives, factory workers.

What does finger tip mean?

Finger tip has three very important structures and these are skin and underlying soft tissue, bone and nail. Nails are of not much importance in human being . It has only aesthetic importance. Bone give stability to skin. Skin on finger tip is highly sensitive, soft.

Importance of finger tip 

Finger tip in human being has special importance. We all can identify objects only by feeling it. This is possible only with normal finger tip. Finger tip has special sensory receptor in finger tip which assess  size, shape, consistancy, temprature of and object are identified. children explore their surrounding during their development period.

What is finger tip injury

finger tip injury due to any reason may damage either skinand soft tissue or nail or bone or combination of all these  structures. This injury give you wound of variable size and shape on tip

What is bad finger injury treatment

After proper treatment one should have soft , painless , sensory finger tip of almost normal shape. If your surgeon does not have experience in operating finger tip it can ruin your hand . if it is painful, non-sensory you will not be able to use your finger. If finger tip is not soft and your skinis stuck with bone below you will always feel pain when you touch an object.

Whom should you consult after injury

best finger tip injury management is done by a reconstructive plastic surgeon who has good experience in operating hand injuries. he helps you achieving almost normal looking soft pain-free functioning finger tip.