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