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Medical Author:

Chad Tarr, MD

Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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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)

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