Open Crushing Injuries of the Hand

Abstract

A severe injury of the hand requires early skilled treatment to save tissue and restore maximal function. The foundation of the primary operative treatment is the removal of all the devitalized tissue; however, debridement must not sacrifice any living part that may be useful for repair or closure. Repair of deeper structures may have to be restricted initially. Satisfactory reduction and stabilization of fractures are primary goals. Suture of divided nerves often is helpful, but repair of flexor tendons is not indicated in crushing injuries. Primary wound closure is another aim of initial treatment.