Emergency Management of Nerve and Tendon Injuries of Hand

Traumatic hand injuries can lead to major disabilities. Due to high number of young active people who can be affected with such disabilities finding the results of emergency tendon and nerve repairs would give us a guideline in managing such injuries. In a prospective study 91 patients (87 males 4 females) were randomly selected among the referrals to an orthopaedic emergency of a hospital in Mashhad Iran. The patients had a mean age of 26.6 years. Demographic information and details of the injuries were recorded before surgery and also in the post operative period with 18 months follow-up. The average size of the skin wounds was 4.4 centimeters and the majority had sharp edges. The most commonly injured tendons were flexor digitorom superficialis flexor carpi radialis extensor digitorom communis and extensor policis longus. The most common complication was joint stiffness which had a direct relation with inadequate physiotherapy. Ulnar nerve repair had a worse outcome compared with median nerve repair. None of the repaired nerves obtained full sensory and motor recovery. Repair of tendon and nerve injuries in emergency settings does not uniformly give good results. It is best not to attempt repair of nerve injury or more than three extensor flexor tendon injuries in emergency room.