Soft-Tissue Defect of the 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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