Damage to the hand is one of the main reasons for access to First Aid: fractures, distortions, trauma to the hand, wrist and fingers are particularly common injuries.
Dr. Alberto Lazzerini, Head of Hand Surgery in Humanitas, spoke about this topic as a guest in the studio at All Health on Rai3.
The hand makes an infinite series of movements that in turn are the whole of a huge number of gestures. The movements we make, even if they appear to be elementary, are the result of the synergy of all the muscles, bones and joints of the hand. It is an extraordinary machine that requires very little maintenance, but should not be overlooked,” says Dr. Lazzerini.
What are the most frequent traumas?
Wrist fractures are certainly the most frequent traumas, compared to all the bones of the hand, which are numerous and can break or encounter fractures and each has specific treatments. The bones are then joined by ligaments, which can tear apart. They are very important lesions, which may not be evident at the moment; the patient drags them along for a long time and when symptoms begin to appear, it is late for primary treatment. Moreover, there are dislocations, wounds, crushing traumas and amputations.
In case of amputation it is best to follow some precautions: the amputated piece should not be disinfected and should not be wetted. It is wrapped in a gauze or handkerchief, put it in a sealed plastic bag and the bag is immersed in water and ice. When stored in this way, a distal segment can be replanted many hours later,” explains Dr. Lazzerini.
What are the examinations for diagnosis?
In the presence of a trauma affecting your hand it is best to go to the First Aid, especially if the trauma generates pain, swelling, motor incapacity or deformities. The patient will then be subjected to the examinations for diagnosis.
In addition to radiography, which is useful for bone traumas, the patient – depending on the case – can be subjected to ultrasound scanning, which allows to observe tendons; ultrasound scanning with Doppler, which also allows to verify the functioning of vessels and electromyography, an examination that verifies whether a nerve functions properly or not “.
What treatments are available today?
It is first important to identify the type of damage as soon as possible and then proceed to the most appropriate treatment, which in the case of fracture it may not necessarily be an external plaster or fixer.
External fixators have played an important role in the past, and today they are a temporary means in extremely fragmented fractures to give a certain degree of stability before plaque or in highly exposed fractures, where bone is polluted and there is a risk of infection, thus plaque is avoided.
Today, especially in the case of wrist fractures, surgery allows us to obtain results that were not imaginable until a few years ago. The fracture can be simple and affect a piece of bone or involve the joint. In this case it must be reconstructed perfectly, otherwise the joint stops working properly and degenerates.
The patient will then have to undergo a rehabilitation path, this counts as much as the surgery and must be conducted for the necessary time with a hand therapist,” concludes Dr. Lazzerini.