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.
You may need to have immediate surgery. If your injury is less severe, your hand will be dressed and splinted. You will have a follow-up visit with a hand surgeon.
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:
HandCare—American Society for Surgery of the Hand
OrthoInfo—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Foundation
The Canadian Society of Plastic Surgeons
Fingertips injuries/amputations. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00014&return_link=0. Updated August 2011. Accessed December 30, 2013.
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, et al. High-pressure plastic injection injury of the hand: case report. Occup Med (Lond). 2011 Aug 8.
Neumeister MW, Brown RE. Mutilating hand injuries: principles and management. Hand Clinics. 2003;19:1-15.
Snowblower and lawnmower injuries. American Society for Surgery of the Hand HandCare website. Available at: http://handcare.assh.org/Portals/1/SnowblowerInjuries%20WEB%20ONLY.pdf. Accessed December 30, 2013.
Tintinalli JE, Kelen GD, et al. Tintinalli’s emergency medicine: A Comprehensive Study Guide. 6th Ed. United States: The McGraw-Hill Companies; 2004; Chapter 268, Injuries to the Hand and Digits.
4/25/2014 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Bruno MA, Weissman BN. 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 December 2014 by Michael Woods, MD
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.