Flashcards in Hand Injury Assessment Deck (15):
Why may you not want to suture a hand laceration?
What are the principles of management for the patient who presents with a hand injury?
General medical Hx
What are the principles of management for the hand when someone presents with a hand injury?
Mechanism of injury
- Splint in intrinsic plus position
- Clean wounds
- +/- Abx
- Tetanus status
What is the intrinsic plus position?
Safe position for hand
- Wrist extended to <10 degrees max
- MCP joints at 60-70 degrees of flexion
- IP joints fully extended
What should you examine in a hand injury?
- Nailbed blancing
- Compare to other side if there's any doubt
Bone and joint
What are the considerations to be made in a complex hand injury?
How do you examine the vascular supply of the hand when it's injured?
- Blanch time
What is the antibiotic prophylaxis for a human bite?
First generation cephalosporin
Metronidazole to cover Gram +ve anaerobes
What is the management for a cut injury?
Repair of deep structures
Healing by primary intention
What is the management for a crush injury?
Remove all non-viable tissue to ward off infection
What skin is likely to survive in a shear injury?
Only skin freely bleeding from cut edge
What is the management for puncture wounds?
Carry organisms deep into tissue > thorough cleaning difficult without extensive exploration
Excise and irrigate wound
What is tenosynovitis?
Infection within tendon sheath
What is the clinical presentation of tenosynovitis?
Fusiform swelling of digit
Partially flexed posture
Tender along sheath
Pain with passive extension