ABSTRACT
The most common complication of any hand injury is stiffness, which results from the collaborative effects of inflammation, swelling, and immobility. Optimum bone and joint reconstruction goals are prompt anatomic reduction of injury and stable skeletal fixation with the least amount of additional soft-tissue disruption. Complications resulting from pediatric hand fractures, dislocations, and soft-tissue injuries are most commonly caused by a failure to identify and treat an injury requiring surgery. The generic “safe position” for hand immobilization is intended to prevent the usual pattern of stiffness after hand disuse. Hand injuries involving traumatic amputation most often affect the fingers. The associated nerve injury always forms a neuroma, and the treating surgeon should trim the digital nerve ends away from the distal wound so as to lessen the chance of disabling scar tenderness. Fingertip injuries that involve the “critical contact areas” of the thumb, index, and middle fingers pose particularly difficult challenges for reconstruction.
