Nerve Lacerations of the Hand
What is a Nerve Laceration of the Hand?
A nerve laceration of the hand refers to a cut or tear involving one of the hand’s major nerves—most commonly the median, ulnar, or radial nerves. These nerves control sensation and muscle function in the hand and fingers. When a nerve is lacerated, it can lead to numbness, muscle weakness, and even permanent loss of hand function if not treated promptly. Nerve injuries are often associated with tendon and vessel damage and typically require surgical intervention.
Causes of Nerve Lacerations of the Hand
Nerve lacerations often occur from penetrating injuries involving sharp objects. Common causes include:
- Knife wounds, including kitchen accidents
- Broken glass injuries
- Power tool or machinery accidents
- Animal bites
- Deep lacerations from motor vehicle accidents or falls involving sharp debris
Because nerves are located near the surface in the wrist and hand, even small cuts can result in significant nerve damage.
What are the Symptoms of a Nerve Laceration?
Symptoms depend on which nerve is injured, but common signs include:
- Numbness or tingling in the fingers or hand
- Loss of feeling in a specific area (e.g., thumb and index finger for median nerve injuries)
- Muscle weakness or paralysis in part of the hand
- Loss of fine motor control, such as difficulty buttoning clothes
- Clumsiness or dropping objects
- Visible wound with exposed tissue or nerve
- If multiple structures are involved, symptoms may also include tendon dysfunction and bleeding.
How is a Nerve Laceration Diagnosed?
Diagnosis begins with a detailed physical exam and is often confirmed with imaging and nerve studies:
- Neurological exam, assessing sensory and motor function
- Tinel’s sign, a tapping test used to check nerve irritation
- Electrodiagnostic studies (EMG/NCS), used later in recovery to assess nerve healing
- Ultrasound or MRI, sometimes used to visualize nerve damage
- X-rays, to check for bone or foreign body involvement
What are the Treatment Options for a Nerve Laceration?
Treatment depends on the severity and timing of the injury:
- Surgical nerve repair, typically within days of the injury, using microsurgical techniques
- Nerve grafting, when the nerve gap is too large to suture directly
- Splinting, to protect the repaired area
- Physical therapy, including sensory re-education and motor retraining
- Pain management, especially if nerve pain (neuropathy) develops