Hand Injuries in the Emergency Department by Peter Houpt;

Author:Peter Houpt; [Houpt, Peter]
Language: eng
Format: epub
ISBN: 9781000684414
Publisher: CRC Press (Unlimited)
Published: 2022-03-15T00:00:00+00:00

8

Flexor tendon and nerve injuries

DOI: 10.1201/9781003313540-8

Introduction

Most flexor tendon and nerve injuries are caused by a glass or knife injury to the volar side of the hand. An open flexor tendon injury is often accompanied by nerve injury.

Physical examination

Examine the individual flexor tendons. Examine the target area of the nerve that may be intersected. Test the sensibility of both the ulnar and radial side of the injured finger. Compare this with a non-affected side. In children one can stroke the finger with a pen. After nerve transection, sweat secretion is diminished and the skin feels smoother. In case of injuries in the palm of the hand or in the forearm the motor function of the nerves should also tested. A change in nerve function does not necessarily mean that the continuity of the nerve is lost – there may be neurapraxia. Suppress the tendency to place clamps or sutures in the wound; this makes recovery of nerve and vascular injury more difficult. An often-missed injury is the closed avulsion of the FDP tendon of the distal phalanx (‘Jersey finger’). X-ray imaging does not always show an osseous avulsion fragment.

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