Case 1: Complicated Wrist Injury

by nadine on March 25, 2011

Post image for Case 1: Complicated Wrist Injury

History: This patient was in a car accident several days before we saw him.  He was initially treated in a rural clinic, where his open wounds were washed and loosely sutured closed.  He was then referred to our hospital for further treatment.

Pertinent physical exam: On exam, the suture lines are clean, and the area shows no signs of infection.  He was unable to flex any of his fingers or thumb, and the palmar surface of his hand from thumb to ring finger was numb.

Treatment options/What was done: These findings indicate an injury of the median nerve and laceration to most of the tendons to his hand- this requires operative intervention to prevent lifelong disability from this now almost totally useless hand.  A hand surgeon operated on this patient.  The median nerve was repaired and the profundus tendons to all fingers and thumb were repaired.  This photo shows the more natural resting posture of his hand postoperatively (note that in the original photo the fingers and thumb are all extended, and in this postoperative photo, the fingers and thumb are flexed).  His hand was kept splinted for six weeks and then therapy was started to improve hand function.

Corresponding chapters for further information. 6, 26, 27, 32, 33

{ 1 comment… read it below or add one }

t-hassouna May 17, 2011 at 4:03 pm

thanks alot for this site which is truely useful but it would be better to attach more photos that show the exact injuried structures

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