Upon arriving at the emergency department or urgent care clinic, the medical evaluation will include reviewing a patient’s medical history followed by physical examination of the injury. Physical examination consists of an inspection to look at the wound, nerve exam, muscular and tendon exam, and a bone exam. Certain hand injuries will require X-rays to identify fractures or dislocations.
Lacerations and cuts need to be evaluated by a specialist for the depth and involvement of nerves, arteries, muscles, and tendons. Tendon lacerations can be treated at a later date by a hand surgeon with excellent results. It is common for the doctor to clean and close a hand laceration, then recommend tendon repair by a specialist at a later date.
Thermal burns fall within one of the three categories. First-degree burns are superficial (outermost layer of skin) characterized by pain, redness, swelling. Second-degree burns (partial skin thickness) are characterized by blistering. Third-degree burns (completely through all skin layers) are characterized by lack of pain and sensation from the nerve being destroyed. These full thickness burns go through the dermis and affect deeper tissues.
Many types of injuries can lead to compartment syndrome, which is swelling and an increase in pressure that compromises blood vessels and nerves.