Fundamental to the early care of open wounds of the hand is ridding the wound of contaminants by cleansing, care being used meanwhile not to add irritating or toxic chemical agents or new infection. Tendons, nerves, bones, and its joints are vulnerable structures which will not tolerate prolonged exposure to air, and hence must be covered at early operation. At debridement severed nerves other than digital nerves should be tagged or left strictly alone. Tendons should be repaired or left, depending on conditions in the wound. Fractures, other than severe dislocations, are best left alone for later, closed reduction. The injured finger must be supported and immobilized in a flexed position, leaving uninjured parts free, and being certain that they are exercised frequently. The treatment of swelling of the extremity by elevation is simple but ofttimes forgotten. The metacarpal fractures most commonly seen are at the base of the first
KELLAM DS. Injuries of Hand and Wrist, Foot and Ankle. AMA Arch Surg. 1957;75(5):734–735. doi:10.1001/archsurg.1957.01280170044025
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