Emergencies-2
Open Wounds
An open wound involves a break in the skin or tissue that may be caused by, among other things, accident, injury or animal bite. A laceration is a type of open wound, one with jagged, irregular edges.
Open wounds and lacerations typically involve bleeding, redness, swelling, pain, and tenderness. They can occur nearly anywhere on the body, with the upper extremities being a common location for open wounds/lacerations caused by accidents or falls.
Deeper wounds or lacerations may require medical attention to prevent infection and loss of function, due to damage to underlying structures such as bone, muscle, tendon, arteries and nerves. Medical care for wounds and lacerations focuses on promoting healing, preventing complications and preserving function. While important, cosmetic results are not the primary consideration for wound repair.
Treatment of Open Wounds and Lacerations
The first step of treatment is to stop the bleeding of a wound or laceration. While treatment depends on the type and severity of the injury, it can often initially be treated at home by cleaning and bandaging the wound and applying pressure. Severe wounds or lacerations may require emergency medical care. Medication to numb the injured area may be given and wound and laceration repair usually includes cleaning and preparing the wound, and then closing it with staples, special surgical glue or adhesive strips. Deeper cuts may require stitches to repair deep structures, such as connective tissue. Stitches to the skin surface can also help to stop bleeding, protect underlying tissues, and lessen scarring. Antibiotics may also be prescribed to fight infection. In severe cases, minimally invasive surgery may be performed to remove or graft skin. Follow-up care is often required to remove stitches or other materials used to close the laceration, and to monitor the healing process.
Tendon Transfer in the Hand
Tendons connect muscles to bones, allowing muscles to function. When there is damage to the tendon that helps a particular muscle to function, the muscle is essentially paralyzed and can no longer be used.
Tendon transfer is a surgical procedure that takes a healthy tendon from one area of the body and attaches it in an area that is no longer functioning. In the hand, tendon transfer is often used to treat tendon damage that has been caused by nerve injury, muscle rupture or nervous-system injury.
After tendon transfer surgery, a splint or cast is worn for up to 2 months to keep the tendon immobilized. After the splint or cast is removed, physical therapy is usually necessary in order to restore full range of motion.
The Tendon Transfer Procedure
Only a healthy, well-functioning tendon with a good blood supply is used for transfer. It must be taken from an area in which the tendons that remain can still provide the function the transferred tendon was providing.
During the tendon-transfer procedure, which is performed on an outpatient basis, two incisions are made: one to access the tendon being transferred, and one to access the area in which the tendon will be attached. The healthy tendon is then rerouted to the new attachment site, where it is secured with stitches to the targeted bone or tendon.
Broken Finger Surgery
There are 14 bones in total in the fingers (phalanges) of one hand. A break (fracture) in one or more of them that is left untreated can lead to permanent stiffness and pain.
A severe finger fracture may require open reduction surgery, which repositions any displaced bones, allowing the finger to function properly once it has healed. When a broken bone can be aligned with a cast or splint alone, it is referred to as "closed reduction."
Broken Finger Open Reduction
Open reduction surgery is required when a broken finger cannot be repaired by placing it in a cast alone. During open reduction surgery, which is performed under local anesthesia to minimize discomfort, the bones are shifted back to their normal positions, and then held in place with pins, screws or wires.
A cast or splint is put in place to ensure that the repositioned (reduced) bones heal correctly; it is left on for approximately 4 to 6 weeks. The pins, screws or wires may be removed once the finger has healed, or may be left in place so that the bones do not shift over time. After healing is complete, physical therapy is usually prescribed to help bring back flexibility to the finger joint.
Signs of a Broken Finger
The most frequently injured parts of the hand are the fingers. A broken finger can be caused by, among other things, putting out a hand to break a fall; closing it in a door; catching a ball the "wrong" way when playing sports; and boxing. Signs of a broken finger can include the following:
- Pain
- Swelling
- Bruising
- Numbness
- Difficulty moving the finger
- Deformed-looking finger
Swelling can also affect fingers adjacent to the one that is broken.
Call 512.450.1077 to speak with Dr. Robison and Dr. Trussler if you have any questions or comments or to learn more about how we can help you.