Industrial hand injuries consisting of massive necrosis of soft tissue with exposure of the bones and joints are among the most severe encountered in civilian practice. Salvaging and rehabilitating these extremities requires aggressive, purposeful treatment. It is aimed at preserving all salvageable structures, maintaining functional position, and restoring as much motion as possible by mobilization of joints and tendon substitution.

These cases differed so nmuch in area and depth of involvement and in associated damage that conmparative evaluation and statistical analysis is of little value. However, observing these patients several years later, there could be no doubt that the rehabilitative effort was thoroughly justified.

See image in the PDF file

See image in the PDF file

The permanent disability in dorsal injuries consisted of limitation of function of the joint and reduced strength. A serviceable grasp and pinch mechanism was established in all cases.

Palmar and volar injuries have a poorer rehabilitative prognosis. Structural restoration of the hand is of little value unless there will be serviceable sensation and function. Damage to the neurovascular supply was responsible for the only amputation performed in this group.