Why all finger fractures should be referred to a hand surgery service: a prospective study of primary management.

The quality of the treatment of finger fractures by Accident and Emergency Department staff has been prospectively assessed during a six-month period. 678 finger fractures were seen in the A. & E. Department. The primary treatment of 624 of these was performed by the A. & E. staff, but in 169 of these (27%), the treatment was inappropriate. Most management errors were elementary; they included failure to prescribe antibiotics for compound fractures, failure to reduce displaced fractures accurately and unsatisfactory splintage. It is recommended that all finger fractures should be assessed and treated by surgeons with training in the management of hand injuries.