[Surgery of acute injuries of the forearm and hand].
Wound of the hand must be treated surgically. The order of priority in management of wounded hand is explained. Vascular injuries with ischemia of the extremity or of the parts are of the very few absolute indications for imediate surgery. Though wound excision, stabilization of skeleton, and skin cover, should be done in the first few hours after injury. It is ideal that the tendons and nerves are repaired at the same procedure. Repair of tendons and nerves requires the utmost insight skill and attention to details; and for nerve repair microsurgical technique is required. When there are factors adverse to primary healing (excessive contamination of reduced tissue vitality) and no provision for expert surgery repair of tendons and nerves should be deferred. Primary or deferred primary repair of tendons three or four days after surgery, and primary and deferred surgery of nerves two or three weeks is discussed. Prevention of infection, prevention of oedema in po-operative treatment and proper joint position during imobilization are the main measures to prevent stiffness of the hand. Mechanism, symptoms and early treatment of impending ischemic leasion is explained.
D005543:Forearm Injuries / Q000601:surgery*; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008722:Methods
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