Age, gender, and social history, paying particular attention to handedness, occupation, smoking status, and substance abuse of the patient

Functional status of hand prior to injury

Previous injury or surgery of the hand in question

Manual demands of daily living and overall lifestyle

Past medical and surgical history

Timing and mechanism of injury

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  Trauma: Associated injuries, underlying fractures, dislocations, and neurovascular insult

  
  
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  Infection (if subacute or chronic)

  
  
  
  
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    Type of infection (bacterial, fungal, other)

    
    
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    Operative management to date (debridements, incision, and drainage)

    
    
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    Antimicrobial treatment and any resistance

    
    
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    Local versus systemic signs and symptoms

Advanced Trauma Life Support (ATLS) protocol

Complete upper extremity examination starting with the shoulder, elbow, and hand

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  Brachial plexus injury is most common in motorcycle collisions

Location and size of soft tissue deficit

Specific deficits: Tendon, nerve, muscles, and skin

Wound bed status: Vascularity, exposed structures, and nonviable skin

Motor function: Delineate musculotendinous deficit from neurologic deficit

Sensory function

Plain radiography: Three views of hand, one joint above and below level of injury

Computed tomography (CT): In the setting of comminuted fractures requiring detailed evaluation

Angiography: Evaluate vascular patency for soft tissue transfer, when needed