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Mutilating Hand Injuries

(Hand Trauma; Hand Injury)

by Cynthia M. Johnson, MA

Home | Health Information Center | Disease, Condition, & Injury Fact Sheets | Article

Definition

A mutilating hand injury is severe damage to the hand. It will make it hard or impossible to use the hand. There may be damage to bones, tendons, tissues, nerves, and skin.

Care is needed right away. It can be deadly.

Causes

This problem may be caused by:

Industrial accidents from machines and power tools
Crushing accidents
Burns
Chemical exposure
Car accidents
Farming injuries

Risk Factors

Things that may raise the risk of this problem are:

Jobs that require using dangerous machines
Removing safety guards from machinery, such as power saws or wood chippers
Short-cuts and poor technique while using machines
Not shutting off power to a tool when using hands to work on it
Operating machinery or vehicles under the influence of alcohol or drugs

Symptoms

Hand injuries are visible. Common problems are:

Pain
Ripped skin
Skin loss
Open wounds
Excessive bleeding
Exposed bone or tendons
Amputation of the hand or fingers

Severe Hand Trauma

Diagnosis

The doctor will examine the injury. Anesthesia may be given to block pain during the exam. Nerves and tendons of the hand will be tested.

Images will be taken to look for damage to the bones, nerves, tendons, and skin. This can be done with:

Treatment

Emergency care will be needed. An IV will be started to give fluids and pain medicine.

The goals of treatment are to stop bleeding, manage pain, and repair damage. Options are:

Medicine

Medicine will be given to ease pain and to block pain during medical care. Antibiotics may be given to lower the risk of infection.

People who have not had a recent tetanus vaccination may be given one. It can help the body find and attack the bacteria.

Wound Irrigation

The wound will be flushed with water. It will help to remove any debris that may be trapped in the wounds. This will help to prevent infection.

Hand Surgery

Less severe injury will be dressed and splinted. A surgical plan can be made later.

Surgery may be needed right away for severe injury. The goal is to repair as much damage as possible. They may save some hand function. Several surgeries are often needed for this type of injury.

Rehabilitation

Rehab can help a person get back movement in the hand. It can also help to make changes if there are some limits to hand movement. Rehab may include:

Physical therapy to improve movement
Occupational therapy to help with daily tasks and self care

Prevention

To lower the risk of this problem:

Do not use machinery that is unfamiliar.
Follow all safety instructions when operating tools or machinery. Be especially careful when using snow blowers and lawn mowers.
Do not put fingers or hands near moving parts of machinery.

RESOURCES:

Hand Care—American Society for Surgery of the Hand
http://handcare.assh.org

OrthoInfo—American Academy of Orthopaedic Surgeons
http://www.orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Foundation
http://www.canorth.org

The Canadian Society of Plastic Surgeons
http://www.plasticsurgery.ca

References:

Fingertips injuries and amputations. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/fingertip-injuries-and-amputations. Accessed August 19, 2021.

Mallet finger. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/mallet-finger. Accessed August 19, 2021.

Snowblower safety. American Society for Surgery of the Hand Hand Care website. Available at: https://www.assh.org/handcare/safety/snow-blower. Accessed August 19, 2021.

Last reviewed July 2021 by EBSCO Medical Review Board James Cornell, MD
Last Updated: 8/19/2021

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