If possible, the incision should fall within The minimum necessary length of incision and risk of injury to the Planned incision will give the maximum exposure of the pathology with When choosing the surgical approach to the hand and wrist. There are several factors that are important to consider Treatment of the hand and should be capable of performing a tendon A surgeon who attempts primary suture ofĪ flexor tendon in its digital sheath should have had considerableĮducation, training, and experience in reconstructive surgical Unfavorable conditions by secondary repair of nerves and tendons after Tendons do not require primary repair less harm will be done under The fractures can be dealt with after the cutaneous wound has healed.Įven more important is the necessity to realize that severed nerves and Position of moderate dorsiflexion of the wrist, moderate flexion of theįingers, and moderate abduction and opposition of the thumb, and aīulky dressing is applied to prevent edema.
#Tell about the basic principles of digital techniques skin
Harm will be done if the skin is closed, the hand is placed in a Physician is not trained to care adequately for the bone injury, less Immobilized at the time of the primary treatment. When possible, fractures should be reduced and In some instances, the use of skin grafts is necessary toĪvoid tension. Hand should be closed primarily and this closure must be without Legs should be treated by delayed closure, almost all wounds of the With injuries of the arm, leg, or abdomen, the involved tissue of the Traumatized hand must be cleansed thoroughly but gently. That it is important to protect wounds from contamination and infectionĪnd that adequate help, facilities, and proper instruments must beĪvailable before one starts to care for the injured hand. Should govern the treatment of an injury to the hand. New York: Raven Press, Ltd., 1993:164.)Īll physicians must be taught the basic principles that L: Apply tape, and cut a slot posteriorly. J,K: Place a tubular stocking and overwrap with 6-inch bias. F: Place plaster slabs (4 × 15 inches) dorsally and ( G) around the elbow. E: Place an additional combine around the elbow, which is maintained at 90°. D: Place a combine dorsally and palmarly around the wrist, and wrap the hand with 4-inch cast padding. C: Distribute fluffs evenly about the hand.
B: Place three 2 × 2 inch gauze squares between the fingers. Plaster splints one ½ and one 1-inch tape rope. Stockinette 1 yard of 4-inch stockinette twenty-one 4 × 15 inch Three rolls of 4-inch cast padding two rolls of 6-inch bias Use fourteen 4 × 4 inch fluffs six 2 × 2 inch gauze three combines Reconstruction is to restore enough function to allow the patient to be Although cosmesis is important, the primary purpose of surgical The hand requires careful technique to minimize the formation ofĪdhesions, which tend to bind together the nicely adjusted movable Handle all of the tissues in the extremity. Requiring knowledge of orthopaedic, plastic, microvascular, and Reconstruction of the hand is often a composite problem, Importance of atraumatic surgical technique in reconstructive hand He emphasized the importance of a detailed knowledge of structural andįunctional anatomy of the hand and a basic comprehension of the entire The handīegins in the opposite cerebral cortex and extends from there to the Hand surgery, said, “Next to the brain, the hand is man’s greatestĪsset and to it is due the development of man’s handiwork. Sterling Bunnell (1882 to 1957), the father of modern
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