Soft-Tissue Defect of the Hand



10.1055/b-0034-97734

Soft-Tissue Defect of the Hand

David T. Tang
A 32-year-old right hand–dominant man sustained a through-and-through gunshot wound to the ulnar aspect of the right hand.


Description




  • Ulnar hand soft-tissue defect secondary to acute gunshot trauma.



  • No vascular compromise distally.



  • Fractures of the fourth and fifth metacarpals.



  • Presumed injury to extensor (and possibly flexor) tendons of ring and small fingers.



  • Likely neurovascular injury to ulnar digits.



Work-up



History




  • Age, gender, handedness, and occupation of the patient.



  • Timing and mechanism of soft-tissue deficit




    • Trauma: Associated injuries, underlying fractures, dislocations, neurovascular insult.



    • Infection: Nature of infection (bacterial, fungal, other); operative management to date (incision and drainage); antimicrobial medications; local versus systemic signs and symptoms.



    • Tumor ablation: Tumor pathology, margins, planned radiation and chemotherapy.



  • Previous injury or surgery of the hand in question.



  • Manual demands of daily living and overall lifestyle.



  • Past medical and surgical history.



  • Social history, including smoking status and substance abuse.

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Jun 18, 2020 | Posted by in General Surgery | Comments Off on Soft-Tissue Defect of the Hand
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