title: [Strategies for complex injuries of the hand].
abstract: The quality of the reconstruction, follow-up treatment and care determine the treatment outcome of complex hand injuries. The initial estimation and therapy are decisive. Optimal results necessitate a structured approach with strategic planning, including thorough débridement, precise analysis of the resulting defect and loss of function and if possible unilateral reconstruction and well-founded planning of secondary interventions. Within the framework of the detailed patient clarification the perspectives, possibilities and alternatives must be realistically presented. Taking these fundamental strategic steps into consideration, the primary aims of reconstruction and preservation of function, rapid occupational and social reintegration and avoidance of delayed complications can best be realized. There is no standard approach for these extremely variable injuries. Decisive is that even in cases of apparently harmless injuries, the involvement of functional structures must be considered early in the initial stages.
authors.affiliation: Klinik für Unfallchirurgie, Interdisziplinäres Handzentrum, IHZ, Klinikum rechts der Isar, Ismaningerstr. 22, 81675, München, Deutschland. h.vester@tum.de.
authors.forename: H
authors.initials: H
authors.lastname: Vester
authors.affiliation: Klinik für Unfallchirurgie, Interdisziplinäres Handzentrum, IHZ, Klinikum rechts der Isar, Ismaningerstr. 22, 81675, München, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Deiler
mesh_terms: D000671:Amputation, Surgical / Q000379:methods / Q000534:rehabilitation; D003131:Combined Modality Therapy / Q000379:methods; D003646:Debridement / Q000379:methods*; D019317:Evidence-Based Medicine; D005858:Germany; D006230:Hand Injuries / Q000175:diagnosis / Q000628:therapy*; D063987:Hand Transplantation / Q000379:methods; D006801:Humans; D008866:Microsurgery / Q000379:methods*; D009104:Multiple Trauma / Q000175:diagnosis / Q000628:therapy*; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*
keywords: Amputation; Microsurgery; Reconstructive surgery; Replantation; Revascularization