Approach to mutilating hand injuries.

Mutilating hand injuries are a challenge to manage due to the complex nature of the injury and the variety of structures that are damaged. Good results can only be achieved by careful planning and management. The ultimate desired outcome is achievement of a normal function of the hand and upper limb. Mutilating hand injuries occur in a variety of settings and the extent of injury and the prognosis varies according to the aetiology of the injury. The management approach focuses on the attention to the repair and reconstruction of individual parts of the hand including the bones, vessels, nerves, tendons and skin cover. Consistent results can be achieved by early aggressive management of damaged structures followed by regular physiotherapy which are the keystones for restoration of form and function of the mutilated hand.