Paediatric Hand Injuries

Dr Brigid Corrigan

Plastic Surgery Registrar

Assessment

• Vascular supply

• Nerve Fuction: Sensory and Motor

• Tendons

• Bone

• Soft Tissue Cover

• Remove Jewellery!

Hand Fractures

• Open vs Closed

• Open: Risk of osteomyelitis– Early thorough washout/debridement– Antibiotic prophylaxis– Definitive Fixation

Hand Fractures

• Closed Fractures: Assessment– ? Displaced on xray– Clinical deformity – angulation, displacement– ?Neurovascular compromise

• Management– Reduction +/- fixation– Immobilisation– Rehabilitation

Hand Fractures

Hand Fractures

Hand Fractures

Hand Fractures

Foreign Bodies

Nail Bed Injuries

Flexor tendon Injuries

• Zones of Injury

• Repair: Strength vs glide

• Post op: splinting, physiotherapy

Extensor Tendon Injuries

• Assessment

• Repair

• Post op splinting/phsiotherapy

• Mallet Finger Injury

• Boutonniere deformity

Nerve Injuries

• Anatomy: Median/ulnar/radial

• Digital nerves

• Nerve repair

• Nerve recovery: 1mm/day

• Post op splinting

Replantation

Replantation

Replantation