COMPLEX TRAUMA OF THE HAND

The hand is very exposed to injuries in the daily man's work. The mult iple functions of the hand are based on vitality, sensibility, motor f unction and stability in severe hand injuries the functional results o f the repair are often very poor. ln a complex injury of the hand we a re faced with the damage of the soft tissue and bone and the loss of v itality and function of the hand. The cause of hand injuries are mainl y a crush trauma or the rotating saw. Basically, we recommend an exten ded primary repair. After the radical debridement we have to reconstru ct the damaged structures. We start doing the osteosynthesis and stabi lization of the joints. Thereafter, suturing of extensor and flexor te ndons. Then, we do the microsurgical reconstructions of vessels and ne rves. In case tendons and bones are exposed we have to cover the defec t with a pedicled or a free flap. In a long ischemic time we have to c hange our concept and do the reconstruction of the vessels first. Our results in vitality and sensibility are listed. In the result of a com plex hand injury each single functional restoration is very important. Therefore, it is necessary that severe hand injuries are treated at w ell established centres for hand surgery.