Hand injuries are the main reason people go to the ER: fractures, strains, trauma to the hands, wrists and fingers are common injuries.
Said Dr. Alberto Lazzerini, Head of Hand Surgery at Humanitas, and guest of the Tutta Salute program exhibited on Rai3.
“Our hands make a series of movements which in turn are a set of gestures. Our movements seem basic, but are the result of the synergy of all the muscles, bones and joints of the hand. It’s an extraordinary machine that requires little maintenance but should not be neglected”, says Dr. Lazzerini.
What are the most common injuries?
“Pulse fractures are by far the most frequent injuries, where all the bones in the hand – which are many – can break and fracture but there is a specific treatment for each of these traumas. Bones are connected by ligaments that can tear; and these traumas are important injuries that may not become evident when it happens. If the patient takes too long to seek help and wait for the symptoms to appear, it may be too late for a primary treatment. Then we see dislocations, wounds, injuries from crushing and amputations.
In case of amputation, some precautions should be followed: the amputated piece should not be disinfected and should not be wet. It should be wrapped in gauze or a wipe. You can put it in a sealed and purged plastic bag and the bag should be immersed in ice water. If the amputated piece is preserved this way in a separate compartment, it can be replanted even after many hours”, explains Dr. Lazzerini.
Which tests need to be done for the diagnosis?
“If there is a hand injury, the person must go to the ER, especially if the trauma causes pain, swelling, motor deficiency or deformity. The patient will therefore, undergo diagnostic tests.
Besides the X-ray to check for bone trauma, depending on the case, the patient may undergo an ultrasound to check the tendons, a Doppler ultrasound, to check the function of blood vessels and an electromyography, a test by which it is established whether a nerve works well or not.
Which treatments are available today?
“First, it is important to quickly identify the type of damage and then proceed to a more appropriate treatment in case the fracture does not require a plaster or an immobilizing sling.
Immobilizing slings have played an important role in the past, today they are a temporary help in highly fragmented fractures to give a certain degree of stability before placing a plaque. On open fractures where the bone is contaminated and there is danger of infection, it is best not to put the plaque.
Today, especially in wrist fractures, surgery allows for results that, until a few years ago, were unimaginable. The fracture can be simple, affect a piece of bone or can be a joint fracture, which involves the joint. In this case, the bone must be reassembled to perfection; otherwise, the joint stops working properly and degenerates.
The patient will have to undergo a rehabilitation treatment. This treatment is as important as surgery and should be done for as long as necessary with a skilled physical therapist“, concludes Dr. Lazzerini.