A mutilating hand injury is severe damage to the hand. The injury may include damage to bones, tendons, soft tissues, nerves, and skin. It can become a life-threatening condition.
If you have this type of injury, call for medical help right away. Immediate care may result in a better repair and decrease the chance of further damage. Untreated, this can lead to a serious infection.
Mutilating hand injuries can be caused by a variety of factors, including:
Factors that may increase your chance of injury include:
Injury to the hand is obvious. Bone, tendons, skin, nerves, and soft tissue may all be damaged. Common symptoms include:
When you are brought to the emergency room, a doctor will quickly assess your injury. Your wound will be inspected and your hand’s nerves and tendons will be tested. You will be asked to explain how the injury happened. You will also be asked which of your hands is dominant.
Imaging tests assess damage to the bones, nerves, tendons, skin, or other soft tissues. These may include:
You may need examination under anesthesia to:
Immediate treatment is focused on stopping any bleeding. The doctor will make sure your vital signs are stable. An IV will be started to give you fluids and medications. You may be referred to a hand specialist for surgery. Depending on your injury, you may receive the following treatment:
The following types of medication may be given:
Sterile saline is used to clean the wound. This will help prevent infection and further injury.
Immediate surgery may be needed. If the injury is less severe, the hand will be dressed and splinted. A follow-up visit with a hand surgeon will be needed.
The type of surgery necessary depends upon the injury. Examples include fusing damaged joints and reattaching fingers. Often, several surgeries are necessary for this type of injury.
To help reduce your chance of a hand injury:
Hand Care—American Society for Surgery of the Hand
OrthoInfo—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Foundation
The Canadian Society of Plastic Surgeons
Fingertips injuries and amputations. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00014&return_link=0. Updated July 2016. Accessed November 13, 2017.
Hammig B, Jones C. Injuries related to snow blowers in the United States: 2002 through 2008. Acad Emerg Med. 2010;17(5):566-569.
Kamrani RS, Mehrpour SR, Aghamirsalim MR. High-pressure plastic injection injury of the hand: case report. Occup Med (Lond). 2011;61(7):518-520.
Neumeister MW, Brown RE. Mutilating hand injuries: principles and management. Hand Clinics. 2003;19(1):1-15.
Snowblower and lawnmower injuries. American Society for Surgery of the Hand Hand Care website. Available at: http://www.assh.org/handcare/hand-arm-injuries/Snowblower-and-Lawnmower-Injury-prevention. Accessed November 13, 2017.
4/25/2014 DynaMed Plus Systematic Literature Surveillance. http://www.dynamed.com: Bruno MA, Weissman BN, Kransdorf MJ, et al. American College of Radiology (ACR) Appropriateness Criteria for acute hand and wrist trauma. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/AcuteHandAndWristTrauma.pdf. Updated 2013. Accessed April 25, 2014.
Last reviewed November 2017 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.