Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Sep-Oct;10(5):849-852.
doi: 10.1016/j.jcot.2019.08.004. Epub 2019 Aug 9.

Approach to mutilating hand injuries

Rajiv Agarwal  1 , Devisha Agarwal  2 , Mallika Agarwal  3
Affiliations
Review

Approach to mutilating hand injuries

Rajiv Agarwal et al. J Clin Orthop Trauma. 2019 Sep-Oct.

Abstract

Mutilating hand injuries are a challenge to manage due to the complex nature of the injury and the variety of structures that are damaged. Good results can only be achieved by careful planning and meticulous management. The ultimate desired outcome is achievement of a normal function of the hand and upper limb. Mutilating hand injuries occur in a variety of settings and the extent of injury and the prognosis varies according to the aetiology of the injury. The management approach focuses on the attention to the repair and reconstruction of individual parts of the hand including the bones, vessels, nerves, tendons and skin cover. Consistent results can be achieved by early aggressive management of damaged structures followed by regular physiotherapy which are the keystones for restoration of form and function of the mutilated hand.

Keywords: Hand injuries; Mangled hand; Mutilating.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Showing a mutilated hand following a cracker blast injury with amputation of index finger and partial loss of middle finger, ring finger, little finger and thumb tip with unhealthy raw areas.
Fig. 2
Fig. 2
A 32-year-old male suffered a sharp laceration across the palm with incomplete amputation of the thumb at the level of base of proximal phalanx.
Fig. 3
Fig. 3
A fracture of the proximal phalanx of the middle finger being treated by open reduction and internal fixation by miniplating.
Fig. 4
Fig. 4
A defect of the long flexor in the zone II region being reconstructed by a tendon graft in the little finger.
Fig. 5
Fig. 5
A compound defect in the mid palm and distal wrist resurfaced by a free radial artery forearm flap.
Fig. 6
Fig. 6
Early physiotherapy and rehabilitation helps in faster recovery.
See this image and copyright information in PMC

References

    1. Alphonsus K.S., Chong Principles in the management of a mangled hand. Indian J Plast Surg. 2011;44(2):219–226. - PMC - PubMed
    1. Tintle S.M., Baechler M.F., Nanos G.P., Forsberg J.A., Potter B.K. Traumatic and trauma-related amputations: Part II: upper extremity and future directions. J Bone Joint Surg Am. 2010;92:2934–2945. - PubMed
    1. Neumeister M.W., Brown R.E. Mutilating hand injuries: principles and management.(v) Hand Clin. 2003;19:1–15. - PubMed
    1. del Pinal F. Severe mutilating injuries to the hand: guidelines for organizing the chaos. J Plast Reconstr Aesthet Surg. 2007;60:816–827. - PubMed
    1. Amputations H.J. Of the fingers and hand: indications for replantation. J Am Acad Orthop Surg. 1998;6:100–105. - PubMed