Hand Trauma & Injuries

Hand trauma and injuries are usually caused by accidents or a result of repetitive use.

Common causes of hand trauma and injury include:

• Impact during recreational activities or sports. These can range from a simple sprained finger from a sudden twist, to knuckle fractures from a hard knock, or mallet finger from a ball hitting the tip of your fingers.

• Accidents such as mishaps in the kitchen which can lead to cuts and burns, or the impact from breaking a fall with your hands.

• Wear and tear from ageing or overuse, which could lead to arthritis as well as strains and sprains from heavy lifting or poor technique.

• Use of certain tools, equipment or heavy machinery involving high pressure, extreme temperatures or moving parts.

Hand injuries can happen to anyone, at any time and when you least expect it.

Risk factors of hand injury

The risk of finger, hand, or wrist injury is higher in contact sports, such as wrestling, football, and in high-speed sports, such as biking and skateboarding. Sports that use hand equipment such as hockey sticks or racquets also increase the risk of injury.

In children, most finger, hand, or wrist injuries occur during sports or play or from accidental falls. Older adults are at higher risk for injuries and fractures because they lose muscle mass and bone strength as they age. They also have more problems with vision and balance, which increases their risk of accidental injury.

Hand injuries can happen to anyone, at any time and when you least expect it. You can reduce your risk and help prevent injuries by being careful.

Preventing hand injury

• Being attentive while working or performing daily tasks.
• Using the correct technique while cutting, gripping and lifting.
• Taking regular breaks to relieve pressure on your hands.
• Using protective gear while playing sports or using heavy equipment, including gloves and wrist guards.
• Stretching and warming up before playing sports can help prevent injuries.

The symptoms of hand trauma vary depending on the type of injury, how it occurred, its depth, severity and its location. Common symptoms of hand trauma include:

• Burns – tenderness or complete numbness, deformity (with or without tissue loss), discolouration, loss of tissue, change in skin texture, redness, blistering, black areas of tissue

• Fractures and dislocations – tenderness, deformity, swelling and discolouration, decreased range of motion (difficulty moving), numbness, weakness, bleeding

• High pressure injuries – pain, swelling, occasional skin discolouration

• Infections – tenderness, localised warmth, redness, swelling, fever (rare), deformity, decreased range of motion

• Lacerations – tenderness, bleeding, numbness, decreased range of motion, weakness, pallor (pale or bloodless appearance)

• Soft tissue (flesh) injuries and amputations – tenderness, deformity (with or without tissue and bone loss), swelling and discolouration, bleeding, weakness, numbness

Diagnosis of hand trauma and injuries vary and typically include:

Clinical examination

In a clinical or physical examination of the hand, your doctor will examine your wound or injury and test for nerve and muscular function.

Imaging tests

To test for injuries that are not visible to the naked eye, X-rays, CT scans, MRI scans and electrodiagnostics can help to identify fractures, dislocations or the presence of foreign objects.

Treatment varies according to the type of injury and its severity. Severe or complicated injuries or trauma may sometimes require surgical intervention but general care may be practiced for these:

• Lacerations or cuts need to be cleaned and pressure applied to stop the bleeding. If the item that caused the cut is still embedded, do not remove it and seek medical attention instead. The cut will then need to be dressed to prevent contamination.

• Fractures (broken bones) and dislocations should be immobilised or place in a splint where possible. If the fracture has resulted in an exposed bone, covered it with a clean cloth to prevent dirt from getting into the wound and seek immediate medical attention.

• Soft tissue injuries can be iced to relieve pain and swelling.

• Amputations require immediate medical attention. Cover the injury with a clean, damp cloth and elevate the hand above the heart to reduce bleeding. If it’s possible to retrieve the amputated part, it should be kept damp and cool but not in direct contact with ice.

• Infections should be kept clean and dry, and usually require antibiotics. A severe infection may require draining and removal of dead tissue.

• Burns caused by heat can be cooled with water, while chemical burns should be cleansed with a lot of water. The burn should then be covered until you can see a doctor.

What appears to be a mild injury may be more serious than you think, so any trauma or injury to your hands should be seen by a doctor, to rule out any permanent damage and to receive the necessary care and medication you may need.

See a doctor immediately if you experience any injury or pain that does not get better with home treatment such as ice and rest, or if the pain, swelling or bleeding gets worse.

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Hand trauma and injuries can lead to lasting damage if treatment is delayed or neglected.

Bone deformities (malunions)

A broken hand can heal by itself. But without proper treatment, the bones might not line up properly and are more likely to heal incorrectly. This condition is known as a malunion and it can lead to impairment of hand function.

Delayed union and nonunion fractures

A fracture that takes longer to heal than usual is called a delayed union. A nonunion fracture is a fracture that has no potential to heal without medical intervention such as surgery.

Bone infection (osteomyelitis)

Infections can occur when bacteria enter the body during a trauma. Less commonly, infections can happen during a bone surgery.

Nerve or blood vessel damage

Trauma to the hand can injure adjacent nerves and blood vessels. Seek immediate attention if you have numbness or circulation problems.

Osteoarthritis

Bone fractures that extend into a joint can cause arthritis years later. If your hand starts to hurt or swell long after an injury, see a hand specialist to get an assessment.