title: Approach to traumatic hand injuries for primary care physicians.
abstract: OBJECTIVE
  To review the initial management of common traumatic hand injuries seen by primary care physicians.
  
  
  METHODS
  Current clinical evidence and literature identified through MEDLINE electronic database searches was reviewed. Expert opinion was used to supplement recommendations for areas with little evidence.
  
  
  RESULTS
  Primary care physicians must routinely manage patients with acute traumatic hand injuries. In the context of a clinical case, we review the assessment, diagnosis, and initial management of common traumatic hand injuries. The presentation and management of nail bed injuries, fingertip amputations, mallet fingers, hand fractures, tendon lacerations, bite injuries, and infectious tenosynovitis will also be discussed. The principles of managing traumatic hand injuries involve the reduction and immobilization of fractures, obtaining post-reduction x-ray scans, obtaining soft tissue coverage, preventing and treating infection, and ensuring tetanus prophylaxis.
  
  
  CONCLUSIONS
  Proper assessment and management of traumatic hand injuries is essential to prevent substantial long-term morbidity in this generally otherwise healthy population. Early recognition of injuries that require urgent or emergent referral to a hand surgeon is critical.
authors.affiliation: McMaster University, Plastic and Reconstructive Surgery, Department of Surgery, 4E12, 1200 Main St W, Hamilton, ON L8N 3Z5, Canada. kevin.cheung@medportal.ca
authors.forename: Kevin
authors.initials: K
authors.lastname: Cheung
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hatchell
authors.forename: Achilleas
authors.initials: A
authors.lastname: Thoma
mesh_terms: D000328:Adult; D000673:Amputation, Traumatic / Q000628:therapy; D001733:Bites and Stings / Q000175:diagnosis / Q000628:therapy; D006230:Hand Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D017053:Infection Control; D007239:Infections / Q000188:drug therapy; D008297:Male; D009262:Nails / Q000293:injuries; D011312:Pressure / Q000009:adverse effects; D011320:Primary Health Care; D011859:Radiography; D012017:Referral and Consultation; D013708:Tendon Injuries / Q000175:diagnosis / Q000628:therapy; D013717:Tenosynovitis / Q000175:diagnosis / Q000628:therapy; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000209:etiology / Q000601:surgery