If you are like most people, you probably do not give much thought to your hands.  Take a moment to look at your hand.  Your finger prints, like snowflakes, no two are alike.  Look at your palm, slowly bring your fingertips together.  You may not have realized it but no other creature on the planet can do that.  The hand is an amazing piece of work that gets little recognition for its accomplishments.

 

During the course of our lives our hands take a beating.  As a result, hand injuries are a common occurrence.  Each year 16 million people seek medical care for some type of hand trauma and records show that this has steadily increased over the past 10 years.  The importance of the hand in daily use is seldom appreciated until an injury forces a change in our lifestyle.  Consider the countless adjustments you would have to make if you lost the use of one or both hands.

 

Anatomically, the hand, containing 27 bones, is a functional marvel that serves multiple purposes.  Its structure enables us to grasp and hold objects, it is also a highly specialized sensory organ with receptors so refined they can differentiate tiny objects by shape, size, and temperature allowing the hand to function as a precision instrument.  The thumb, offset from the other fingers, is able to touch the other four, a characteristic that is unique to humans.  The bones give it its basic structure, but the overlying soft tissues enable it to move with the 30 pair of muscles. 

 

Due to their position, environmental exposure, and near-constant use, the hands are at high risk for injury.  Soft tissue injuries are the most common.  Some common injuries are closed fist or “fight bite”.  It is secondary to striking an opponent in the mouth with a closed fist and receiving jagged lacerations over the finger joints from teeth that result in high risk  infections.  Crushing finger injures, such as hammer blows, result in blood under the fingernail and cause severe pressure and pain. Penetrating wounds and impaled objects are also common, with animal bites and industrial accidents heading the list.  Jammed fingers in sports are routine.  Fractures of the hand bones are the most commonly fractured bones in the body.  Sports  head the list among children,  work related accidents are most common in adults, and  the elderly, most occur secondary to falls.

 

Although, most complex injuries occur in an industrial setting, power tools and lawn equipment make the home a hazardous site as well.  Amputations, degloving, and high-pressure injuries are frequent.  Degloving involve traumatic removal of skin and/or destruction of underlying structures, most commonly traced to a ring, watch, or bracelet caught in a piece of machinery.  Grease guns, spraying equipment, and diesel injectors account for most high-pressure injuries involving forceful injection of contaminants into the skin and underlying tissue.

 

Since the hand is so essential all efforts must be made to preserve it,  and its functions.  The most likely life threat will be profuse bleeding, which commonly will stop with direct pressure and elevation.  Do not remove impaled objects.  Amputations require rapid intervention in order to save the affected parts.  Successful surgery depends on a variety of factors, including site affected, severity of tissue destruction, and length of time without oxygen.  It should occur within 6 to 8 hours.  Keeping the amputated part cool, not in contact with ice, adds to the success of regrowth.  These are treated aggressively, especially those involving the thumb.  Depending on the severity, follow-ups can take days or years.