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Hand Injuries (cont.)

Hand Injury Diagnosis

Upon arriving at the emergency department or clinic, the medical evaluation may include a medical history and physical examination.

Medical history questions

  • Past medical history (Does the patient have diabetes or arthritis? Does the patient smoke?)
  • Hand dominance (Is the patient right or left handed?)
  • Occupation, extracurricular activities, and hobbies (How does the patient use their hands?)
  • Mechanism of injury (How did the injury occur?)

Physical examination

  • Visual inspection (look at the injury)
  • Sensory nerve exam (feeling)
  • Vascular exam (circulation or blood supply)
  • Muscular and tendon exam (movement and strength)
  • Bone exam (broken bones or dislocated joints)

Tests

The doctor may order X-rays after the history and physical exam, if warranted. Certain hand injuries will require X-rays to identify fractures or dislocations or to rule out foreign bodies.

After a thorough evaluation, the diagnosis usually falls within one of these common injury categories.

  • Lacerations
  • Fractures and dislocations
  • Soft tissue injuries and amputations
  • Infections
  • Burns
  • Thermal burns
    • First-degree burn: Superficial, involvement of the outermost layer of skin, characterized by pain, redness, swelling
    • Second-degree burn: Partial skin thickness, characterized by blistering
    • Third-degree burn: Extends completely through all skin layers, characterized by lack of pain and sensation
  • Chemical burns
  • Electric burns
  • Cold injury or frostbite
  • Foreign body
  • High pressure infusion (grease gun, paint gun)

Hand Injury Treatment

Home care for hand injuries initially involves proper first aid techniques. In most cases, serious hand injuries will require medical attention.

Lacerations (cuts)

  • Apply pressure to the wound to stop bleeding.
  • If possible, wash dirt or debris from the wound.
  • Cover the wound to prevent further contamination or injury.
  • Do not remove large foreign bodies such as nails, hooks, or knives.
  • Seek medical attention.

Fractures (broken bone) and dislocations

  • Immobilize or splint the hand, if possible.
  • Cover the injury if bone is exposed (open fracture), with a clean towel, cloth, or gauze.
  • Ice may help decrease the pain, but never apply ice for more than 20 minutes at one time, and never apply ice directly to skin.
  • Seek medical attention.

Soft tissue injuries and amputations

  • Apply pressure to stop bleeding.
  • Cover the injury with a damp bandage, if possible.
  • Elevate the hand above the heart to reduce bleeding.
  • Retrieve the amputated body part (if possible). If possible, cover the amputated body part, keep it damp, and place the part (for example, finger or thumb) near ice to cool. Do not place body part in direct contact with ice in order to prevent freezing.
  • Seek medical attention.

Infections

  • Keep the injury clean and dry.
  • Seek medical attention.

Burns

  • Thermal (heat) burn: Cool with water, not ice, and then cover the injury.
  • Chemical burn: Irrigate with lots of water, then cover the injury.
  • Frostbite: Rewarm with warm-water bath or soak, then cover the injury.
  • Seek medical attention.
Medically Reviewed by a Doctor on 4/1/2016
Medical Author:

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