Physiotherapists in Guildford treat many different conditions including the issues profiled below.

Hand Injuries - Prevention

Many hand injuries can be prevented by taking sensible precautions or by avoiding obviously risky behaviours. One of the most common behaviours, especially amongst young men in social situations, is to damage their hands by punching each other or punching objects in anger such as doors or walls. This commonly results in fractures to the metacarpals or fingers, injuries which need careful management for the best functional outcome. The use of knives should be carefully regulated with training and supervision for those who work with them routinely. Separating frozen objects with a pointed knife whilst holding the object is a relatively common reason for stabbing a knife through the palm.

Health and safety regulations should be closely observed when operating machinery or dealing with electrical equipment. Injuries to the hands are almost always preventable with a little planning and forethought. Machinery with moving parts, especially rotational ones, requires operators to avoid wearing gloves or jewellery or loose clothing especially around the cuffs. In other situations gloves of the appropriate type should be used. Hands should not be placed in dangerous positions, so push sticks for saws or brushes to clean away machine debris should be employed.

Hand Injuries - Acute Management

Most injuries, apart from the most minor, benefit from being seen and assessed by a doctor as a relatively minor dysfunction in the hand can cause long term functional disability. Initial management of a hand injury should be to control any bleeding by applying gauze or a clean cloth to the wound and putting some pressure on it. In a closed injury (i.e. no wound) then ice can be applied to the damaged area to reduce inflammation and pain. Jewellery such as rings needs to be immediately removed as hand swelling can be very dramatic, rendering easy removal later impossible.

Once in the Emergency Department the doctor will x-ray the hand routinely and may inject the nerve at the wrist level or at the base of one of the fingers to numb the hand or the finger so that they can examine the area without too much pain. Wounds will be cleaned if they are dirty and then closed by stitching or a related method, with antibiotics prescribed to prevent infection developing. Splinting is often used to immobilise the hand in a specific position to prevent further injury or maintain anatomical integrity. A referral to a hand specialist or a plastic surgeon is typically written and pain control medication will be encouraged for a few days.