Current Principles in the Management of a Mangled Hand

Mangled upper-extremity injuries can have devastating consequences for the patient. The goal of treatment was to recreate a functional hand with a minimum of three sensitive and opposable fingers to achieve an acceptable quality of life. Early management of injuries is critical to treatment success....

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Main Authors: Martina Macrì, MD, Pierfrancesco Pugliese, MD, Graziano Accardo, MD, Alice Clemente, MD, Valentina Cecconato, MD, Simona Odella, MD, Pierluigi Tos, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Journal of Hand Surgery Global Online
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2589514124001518
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author Martina Macrì, MD
Pierfrancesco Pugliese, MD
Graziano Accardo, MD
Alice Clemente, MD
Valentina Cecconato, MD
Simona Odella, MD
Pierluigi Tos, MD, PhD
author_facet Martina Macrì, MD
Pierfrancesco Pugliese, MD
Graziano Accardo, MD
Alice Clemente, MD
Valentina Cecconato, MD
Simona Odella, MD
Pierluigi Tos, MD, PhD
author_sort Martina Macrì, MD
collection DOAJ
description Mangled upper-extremity injuries can have devastating consequences for the patient. The goal of treatment was to recreate a functional hand with a minimum of three sensitive and opposable fingers to achieve an acceptable quality of life. Early management of injuries is critical to treatment success. Initial assessment begins in the emergency department where the injury is quantified and the amputated segments are evaluated, particularly the possibility of replanting them or using them as spare parts as tissue bank. In the operating room, careful debridement is essential for any reconstruction. Despite advances in reconstructive techniques, the management of these injuries is a challenge for the surgeon. The main treatment guidelines and a step-by-step approach to the mangled hand are presented to achieve acceptable results.
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publisher Elsevier
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series Journal of Hand Surgery Global Online
spelling doaj-art-b74d9ace11a64b4baf9485a0eb8c005d2025-08-20T02:55:45ZengElsevierJournal of Hand Surgery Global Online2589-51412025-03-017232633010.1016/j.jhsg.2024.07.009Current Principles in the Management of a Mangled HandMartina Macrì, MD0Pierfrancesco Pugliese, MD1Graziano Accardo, MD2Alice Clemente, MD3Valentina Cecconato, MD4Simona Odella, MD5Pierluigi Tos, MD, PhD6UOC Chirurgia della Mano e Microchirurgia Ricostruttiva – ASST Gaetano Pini – CTO, Milano, ItalyUOC Chirurgia Plastica, Policlinico Giaccone, Palermo, ItalyUOC Chirurgia Plastica, Policlinico Giaccone, Palermo, ItalyUOC Chirurgia della Mano e Microchirurgia Ricostruttiva – ASST Gaetano Pini – CTO, Milano, ItalyUOC Chirurgia della Mano e Microchirurgia Ricostruttiva – ASST Gaetano Pini – CTO, Milano, ItalyUOC Chirurgia della Mano e Microchirurgia Ricostruttiva – ASST Gaetano Pini – CTO, Milano, ItalyUOC Chirurgia della Mano e Microchirurgia Ricostruttiva – ASST Gaetano Pini – CTO, Milano, Italy; Corresponding author: Pierluigi Tos, MD, PhD, UOC Chirurgia della Mano e Microchirurgia Ricostruttiva – ASST Gaetano Pini – CTO, Milano, Italy.Mangled upper-extremity injuries can have devastating consequences for the patient. The goal of treatment was to recreate a functional hand with a minimum of three sensitive and opposable fingers to achieve an acceptable quality of life. Early management of injuries is critical to treatment success. Initial assessment begins in the emergency department where the injury is quantified and the amputated segments are evaluated, particularly the possibility of replanting them or using them as spare parts as tissue bank. In the operating room, careful debridement is essential for any reconstruction. Despite advances in reconstructive techniques, the management of these injuries is a challenge for the surgeon. The main treatment guidelines and a step-by-step approach to the mangled hand are presented to achieve acceptable results.http://www.sciencedirect.com/science/article/pii/S2589514124001518Mangled handReconstructive microsurgeryReplantationRevascularization
spellingShingle Martina Macrì, MD
Pierfrancesco Pugliese, MD
Graziano Accardo, MD
Alice Clemente, MD
Valentina Cecconato, MD
Simona Odella, MD
Pierluigi Tos, MD, PhD
Current Principles in the Management of a Mangled Hand
Journal of Hand Surgery Global Online
Mangled hand
Reconstructive microsurgery
Replantation
Revascularization
title Current Principles in the Management of a Mangled Hand
title_full Current Principles in the Management of a Mangled Hand
title_fullStr Current Principles in the Management of a Mangled Hand
title_full_unstemmed Current Principles in the Management of a Mangled Hand
title_short Current Principles in the Management of a Mangled Hand
title_sort current principles in the management of a mangled hand
topic Mangled hand
Reconstructive microsurgery
Replantation
Revascularization
url http://www.sciencedirect.com/science/article/pii/S2589514124001518
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