Mutilated Hand Injuries
Norman Weinzweig, MD, FACS
Surgeon, Plastic Surgery, Plastic Surgeons
Mutilating or “mangling” injuries of the hand pose a formidable challenge for both the patient and the hand surgeon. These are devastating injuries resulting from industrial, agricultural or power tool accidents. Often, these accidents present as incomplete or complete amputations of the thumb, fingers, hand or even the entire arm. These injuries involve multiple structures including bones, joints, tendons, ligaments, arteries, veins, nerves and soft tissues. The mechanism of injury can be range from guillotine sharp clean-cut injuries with a limited zone of injury to crush-avulsion degloving injuries with an extensive zone of injury.
The key concerns in these patients are salvageability of the mutilated hand followed by repair, reconstruction and rehabilitation. This is a life-changing event requiring a comprehensive team approach providing highly individualized treatment, often over 1-2 years, requiring multiple staged surgical procedures and a prolonged rehabilitation process, to optimize function and pain management. This will entail a multidisciplinary team approach including the hand surgeon, occupational therapist, employer, nurse case manager, psychologist and patient.
, Hand Surgery
, Plastic Surgeons
, Plastic Surgery