Fractures

History

• Age, handedness, contact telephone number
• Date/time of injury, Mechanism of injury, contamination (if open), initial management
• Past medical history, Drug history (anticoagulants?), Tetanus status
• Social history: Occupation, Alcohol/Smoking, Sports/Hobbies

*****REMOVE ALL HAND JEWELLERY*****

If limited by pain, perform after administration of anaesthesia

Examination:

LOOK - Opened or closed injury, dirty or clean, visible deformities, skin color

FEEL - Neurovascular status (before local anaesthetic)

MOVE - tendons – Extension, flexion (FDP/FDS), fractures – Rotation/Scissoring/Shortening

Investigation

• XRAY – AP/Lateral/Oblique
• RE-XRAY IF THE FRACTURE HAS BEEN SPLINTED OR MANIPULATED

Treatment

• Elevate all hand injuries
• Advise regular analgesia
• Splint as necessary dependent on injury and re-xray as indicated

FOLLOW FRACTURE MANAGEMENT GUIDES BELOW