surgery

Trauma management

At the London Hand and Wrist Unit, the majority of our caseload is trauma. We offer a triage service for acute injuries on weekdays. A senior hand therapist will assess the injury and provide immediate care. An X-Ray can be taken if appropriate. Referral to a hand surgeon will be made at the time if surgery is indicated or a further opinion is required. With 14 surgeons in the London Hand and Wrist Unit group, it usually possible to access one with short notice. Please call 020 7483 5090 for an appointment.

Trauma to the hand and wrist can include to bone, muscle, tendon, nerve, other soft tissue (such as ligament), skin and nails. Bony injuries take approximately 6 weeks to heal and need to be in the correct position and alignment for this healing to occur. If the bone is displaced, it may be necessary to surgically fix it. Most fractures need some support during this healing process which may involve casts or thermoplastic splints. When tendons or nerves are damaged, these delicate structures most often require surgical repair, which should be carried out as soon as possible after injury. Specialist hand surgeons use refined, 'microsurgical' techniques to repair tendons, nerves and soft tissues that have been damaged.

Following surgery, the repaired structures will be very vulnerable and will need to be protected. At the London Hand and Wrist Unit the hand therapists see patients following their surgery to commence a post operative rehabilitation programme. A protective splint is custom made, wounds are monitored, dressings changed and where appropriate, exercises are taught for the patient to continue with at home.

Protection of a repaired structure is normally necessary for at least 6 weeks, and therapy continues throughout this time. Once the repaired structures are healed and stronger, therapy is progressed to rehabilitate hand function. The therapists aim to restore optimum range of motion and function in the hand in partnership with the patient. Therapy may be ongoing for several weeks to several months depending on severity of injury and progress made.