Hand Injury Traps & How not to miss them!

Hand Injury Traps & How not to miss them!

Hand injuries account for approximately 20% of all Emergency Department (ED) attendances in the UK. The complexity of hand anatomy means that seemingly minor surface wounds can mask debilitating injuries to tendons, nerves, or joints.

Critical Takeaways:

  • Position of Injury: Wounds must be explored through the full range of motion (ROM) to detect retracted tendon injuries.

  • Fight Bites: Any laceration over the metacarpal head (knuckle) is a human bite until proven otherwise. These require aggressive washout and antibiotics due to high risk of septic arthritis.

  • Rotational Deformity: Scissoring of fingers on flexion is the hallmark of malrotated metacarpal/phalangeal fractures and requires reduction/fixation.

  • Kanavel’s Signs: Recognition of these four signs is vital for diagnosing flexor tenosynovitis, a surgical emergency.


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