These wounds have clearly defined edges with minimal tissue damage. The injury typically results from sharp objects like knives or glass, creating a straight wound path. Assessment focuses on depth and involved structures.
Trauma (Finger Lacerations, Animal Bites)
Dr Jacqueline Tan
MBBS (SG) | MRCS (Edin) | MMed (Surgery) | FAMS (Hand Surgery)
Finger trauma from lacerations and animal bites represents a significant category of hand injuries that can affect the skin, tendons, nerves, blood vessels, and bones. These injuries require prompt medical attention to prevent infection, preserve function, and ensure proper healing of the affected structures.
Symptoms of Finger trauma
Patients with finger trauma may experience various symptoms depending on the depth and extent of injury.
- Pain and Tenderness: Sharp, throbbing, or aching pain at the injury site, often worsening with movement or touch.
- Bleeding: Bleeding may range from mild oozing to significant blood loss, depending on the extent of vessel damage.
- Movement Limitations: Difficulty bending or straightening the finger due to pain, swelling, or structural injury.
- Sensory Changes: Numbness, tingling, or altered sensation in the injured finger, which may indicate nerve involvement.
- Visible Deformity: Noticeable misalignment, swelling, or open wounds with tissue separation, suggesting fractures or severe soft tissue damage.
Causes and Risk Factors
Finger trauma can result from various activities and circumstances, with specific factors increasing the likelihood or severity of injury.
- Occupational Hazards: Jobs involving machinery, sharp tools, or heavy equipment pose a high risk of cuts, crush injuries, or amputations.
- Animal Encounters: Bites from domestic pets or wild animals commonly affect the fingers during handling or feeding, potentially leading to puncture wounds and infections.
- Sports Activities: Contact sports, ball games, and activities involving rapid hand movements increase the risk of fractures, dislocations, or ligament injuries.
- Home Activities: Accidents during cooking, DIY tasks, or gardening frequently result in cuts, burns, or other finger injuries.
Types of Finger Trauma
Finger trauma encompasses several distinct injury patterns that require specific assessment and treatment approaches.
Clean Lacerations
Crush Injuries
These involve compression of finger tissues between hard surfaces. The damage pattern includes irregular wounds, tissue swelling, and potential bone involvement. Multiple structures may be damaged in different planes.
Puncture Wounds
These penetrating injuries create a small entry point but can cause deep tissue damage. The wound track may be difficult to assess fully, and foreign bodies may remain inside. These injuries carry a high infection risk.
Animal Bites
These complex wounds combine crushing force with punctures from teeth. They often create both visible surface trauma and deep tissue damage. The injury pattern varies by animal species and bite force.
Diagnostic Methods
Physical Examination
The clinician assesses wound characteristics, finger movement, and sensation. This includes testing individual finger joints, checking capillary refill, and evaluating neighbouring digits. Documentation includes wound size, location, and depth.
Imaging Studies
X-rays identify fractures, foreign bodies, and joint involvement. Multiple views help determine the extent of bony injury and guide treatment planning. Special views may be needed for specific injury patterns.
Detailed Assessment
In complex cases, a thorough evaluation is conducted to assess tendon function, nerve responses, and vascular status. Imaging techniques, such as MRI may be utilised to provide a clearer understanding of the injury.
Treatment Options
The choice of treatment is determined by the severity of the injury, the structures affected, and the time elapsed since the trauma occurred.
Non-Surgical Treatment
Wound Cleansing
Thorough irrigation and debridement are performed to remove contaminants and devitalised tissue. The process involves the use of antiseptic solutions and may require local anaesthesia. For contaminated wounds, multiple cleansing sessions may be necessary.
Antibiotic Therapy
Antibiotics are prescribed based on the type of wound and contamination level. Animal bites typically require broad-spectrum antibiotic coverage. Treatment duration ranges from 5 to 14 days, depending on the progress of healing.
Dressing Management
Regular wound care with appropriate dressing materials promotes healing. The choice of dressing depends on the wound’s characteristics, including size and drainage levels.
Surgical Treatment
Primary Repair
Clean wounds are directly closed within 6–12 hours of injury. The procedure involves precise alignment of tissue layers using appropriate suture materials. In some cases, staged closure may be required for complex wounds.
Tendon Repair
Divided tendons are repaired using specialised surgical techniques. The procedure demands careful handling of tendon ends and proper suture placement. Post-operative therapy adheres to established protocols to ensure functional recovery.
Nerve Repair
Microsurgical techniques are employed to restore continuity in severed nerves. Under magnification, the surgeon carefully aligns nerve ends. The recovery process requires extended rehabilitation for optimal functional outcomes.
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Prevention and Management
Prevention strategies include using appropriate protective equipment during risk activities, proper tool handling techniques, and careful animal handling practices. For existing injuries, management focuses on wound care compliance, following activity restrictions, and attending scheduled therapy sessions. Regular hand hygiene and protection from further trauma support optimal healing outcomes.
Frequently Asked Questions
How long should I keep my wound dressing dry?
Initial dressings typically stay in place for 24-48 hours unless specified otherwise by your healthcare provider. After this period, specific washing and dressing change instructions apply based on wound type and healing progress.
When can I return to sports activities?
Return to sports varies from 2-12 weeks depending on injury location, severity, and healing progress. Contact sports typically require longer restriction periods to prevent re-injury.
What signs indicate I need immediate medical attention?
Increasing pain, spreading redness, fever, or drainage changes suggest possible infection requiring prompt evaluation. New numbness or colour changes in the finger also warrant immediate assessment.
Dr Jacqueline Tan
MBBS (SG)
MRCS (Edin)
MMed (Surgery)
FAMS (Hand Surgery)
Dr. Jacqueline Tan is a hand surgeon in Singapore with over 18 years of experience in managing hand, wrist, and nerve conditions. Formerly the Head of Department of Hand and Reconstructive Microsurgery at Singapore General Hospital, she has continued to contribute significantly to her profession.
- Director of Micro-Reconstruction Service and the Director of Peripheral Nerve and Paralytic Upper Limb Service
- Upon the completion of her training as a hand surgeon in Singapore, Dr Tan was awarded the prestigious Health Manpower Development Plan scholarship by the Ministry of Health (MOH).
- Completed a one-year advanced fellowship in Taiwan under the tutelage of internationally-acclaimed Hand and Orthopedic Microsurgeon – Professor Yuan-Kun Tu
- Dr Tan’s field of expertise is in early and late brachial plexus reconstruction, peripheral nerve disorders, reconstructive microsurgery of the extremities and wrist disorders.
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Mt Elizabeth Novena Hospital
38 Irrawaddy Road #07-42
Singapore 329563
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