Treatment of severe combined hand injuries

Background. The term severe combined hand injury is often used as a synonym for incomplete amputation, i.e. a combination of open fractures, vascular, nerve and ligament injuries as well as in most cases soft tissue defects. Therapy. Severe combined hand injuries should only be treated in surgical hand replantation centers in which the necessary hand surgical skills are available around the clock (24/7). The treatment approach depends on the circumstances of the accident. The postoperative management has a decisive influence on the success of the treatment. Severe combined hand injuries for which microvascular reconstruction of vessels or surgical flaps are used must, however, be treated with the greatest possible care in the first postoperative week. From the second postoperative day onwards physiotherapy of the operated hand can be initiated. Rehabiliation. Even in the early postoperative phase the rehabilitation manager of the occupation insurance association should be consulted in order to jointly define the future perspectives for the patient. After bone healing has been finalized the next phase of rehabilitation consisting of functional reconstruction can be initiated with the aim of occupational reintegration.