24-year-old mill worker sustained a mutilating injury to his dominant, right hand, resulting in a complete amputation of the radial aspect of his hand.
INJURY:The entrance level was sagittal through the ring finger, moving toward the radial wrist, with a split of the ring finger and transection of the neck and shaft of the third metacarpal, base of the second metacarpal, trapezoid, scaphoid, and radial styloid. The ulnar soft-tissue envelope of the ring finger, still associated with the hand, had good capillary refill. Skeletal fixation was achieved with Kirschner wires driven from the part to the ulnar hand.Flexor tendons were then identified and repaired. Dissection of the median nerve revealed complete transection. Because of the significant zone of injury, the wrist was flexed to allow for tension-free coaptation of the nerve. Similarly, the transected superficial branch of the radial nerve was identified and coapted.
