What are the types of hand injuries?

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Hand injuries can occur in a wide range from a simple skin incision to the loss of a limb. Hand; It is a dynamic structure consisting of complex tissues such as the unique skin and subcutaneous tissue, the vessels that provide the circulation of the hand, the nerves that control the sensation and movement of the hand, the muscles and tendons that provide the movement, and the bones that make up its skeleton. In hand injuries, one and/or more of these tissues may be injured. As the amount of injured tissue increases, the treatment and healing process becomes more complex. In vascular injuries, the blood circulation of the hand is adversely affected, while there is loss of motion in tendon injuries, loss of sensation and movement may occur in nerve injuries. Sometimes the hand can be completely severed from any level. 

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What should be the first response to hand injuries?

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In hand injuries, the cause that caused the injury should be eliminated first. It should be ensured that the machines are stopped especially in the injuries related to the work accident. Especially in injuries such as crushing and squeezing, the hand should be freed from the factor so that the intact tissues are not damaged. If there is contact with foreign objects, water should be kept to clean them. Then, a clean cloth should be wrapped on the wound and pressure should be applied. If bleeding cannot be controlled with pressure, a tourniquet can be applied on the upper arm. In this case, the tourniquet should be loosened at intervals of 15 minutes.

If there is a loss of limb, it should be cleaned with water, put in a bag wrapped in a wet clean cloth, and transported by placing it in another bag filled with ice. One of the biggest mistakes during the transportation of the injured organ is to contact the ice directly with the tissue. In case of hand injuries, a doctor should be consulted quickly. Early surgeries are more successful, especially in arterial injuries that cause circulatory disorders. 

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How are hand injuries treated?

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In hand injuries, the degree of injury is determined by performing a full physical examination of the hand first. Simple interventions can be applied in emergency services. However, veins, nerves, tendon cuts, and limb ruptures should be treated by applying  microsurgery under the microscope in the operating room environment.

Crush injuries constitute the group that is more difficult to treat among hand injuries. Here at the micro level the damage is more than meets the eye. In general, treatment is provided by repairing the affected structure, but especially in cases where repair cannot be achieved, such as crush injuries, vessel, nerve and tendon transplantation may be required. Microsurgical hand surgeries are operations that take a long time, require attention, and require experience. 

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How is recovery after hand injuries?

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Surgery after hand injuries is not sufficient for full recovery. Physical therapy is necessary in complex injuries due to the dynamic nature of the hand. Even if there is improvement in the structures on the hand surgically, functional recovery may take months. Depending on the complexity of the injury, the recovery period may be longer. Compliance and continuation of physical therapy is very important at this point. It is appropriate for patients to be followed up by an experienced hand physiotherapist after hand injuries.

Hand injuries mostly occur with simple carelessness and after work accidents, mostly for preventable reasons. Especially being careful while working with cutting, piercing and pressing tools and taking the necessary precautions for work accidents in the workplaces will reduce these injuries. Thus, hand injuries that cause serious functional, psychological and workforce losses will be reduced.