ABSTRACT
Hand injuries the commonest of all injuries are important out of all proportion to their apparent severity, because of the need for perfect function. Fractures may heal and joints re-stabilize, and yet the patient may still be left with a useless hand because of insufficient attention to splintage, the prevention of swelling, the preservation of movement and rehabilitation. Large wounds and multiple fractures are better dealt with under general anaesthesia. There may be an associated intra-articular fracture at the base of the metacarpals. Fractures of the metacarpal neck may result in forward tilting of the distal fragment. In a closed injury with displaced fragments, tiny buried screws are needed to hold the fragments in place. Partial or complete tears of the ligaments are common and usually due to forced angulation at the joint. Open injuries range from clean cuts to ragged lacerations, crushing, injection of foreign material, pulp defects and amputations.
