Hand Injuries (cont.)

Medical Author:

Chad Tarr, MD

Coauthor:

Philip Shayne, MD

Editor:

Scott H Plantz, MD, FAAEM

Editor:

Francisco Talavera, PharmD, PhD

Editor:

Ron Fuerst, MD

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

Medical history
- Past medical history (Do you have diabetes or arthritis? Do you smoke?)
- Hand dominance (Are you right- or left-handed?)
- Occupation, extracurricular activities, and hobbies (How do you use your 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