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Case Studies | Orthopaedic Surgery | India | Volume 13 Issue 8, August 2024 | Popularity: 5 / 10

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Comprehensive Management of a Mangled Hand - A Case Report

Dr Pranesh E, Dr. Thiagarajan P, Dr. Manimaran Ramachandran

Abstract: Introduction: Crush injury of the hand involves damage to various structures, including tissue loss, injury to vascular structures, and possibly amputated digits. Critical elements of the initial surgery include meticulous and complete debridement, stabilization of bone, vascular reconstruction, and adequate soft tissue coverage if vessels are exposed. Operations that will enhance the functionality of the hands should be included in the follow - up surgery, including bone/skin grafting, bone transport, tendon repair, nerve repair/reconstruction, and flap debulking. For the aesthetic reconstruction of the hand, platelet - derived growth factor collagen granules can be incorporated to ensure adequate tissue granulation, followed by Split Skin Grafting. Case report: This case report discusses the comprehensive management of a 33 - year - old manual laborer who sustained a severe crush injury to his right hand from a stone crusher. Initial treatment included meticulous debridement, bone stabilization with K - wires, and vascular reconstruction. Due to the complexity of the wound, conventional VAC dressing and abdominal flap techniques were deemed unsuitable. Instead, platelet - derived growth factor PDGF ointment and collagen granules were utilized to promote granulation and bone healing. This approach facilitated successful split skin grafting and significant functional recovery, demonstrating PDGFs potential as an effective alternative in complex hand trauma cases. This case report highlights the potential of PDGF ointment and collagen granules as effective alternatives to conventional treatments for severe hand injuries, offering improved granulation and functional outcomes. Conclusion: The purpose of this case report is to detail an alternative approach to managing complex hand trauma using platelet - derived growth factor PDGF ointment and collagen granules for granulation and fracture healing.

Keywords: Mangled hand, Platelet - derived growth factor, K - wire, Granulation, Early surgery

Edition: Volume 13 Issue 8, August 2024

Pages: 158 - 163

DOI: https://www.doi.org/10.21275/SR24729155917

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