by EBSCO Medical Review Board
(Hand Trauma; Hand Injury)


A mutilating hand injury is severe damage to the hand. It will make it hard or impossible to use the hand. There may be damage to bones, tendons, tissues, nerves, and skin.

Care is needed right away. It can be deadly.


This problem may be caused by:

  • Industrial accidents from machines and power tools
  • Crushing accidents
  • Burns
  • Chemical exposure
  • Car accidents
  • Farming injuries

Risk Factors

Things that may raise the risk of this problem are:

  • Jobs that require using dangerous machines
  • Removing safety guards from machinery, such as power saws or wood chippers
  • Short-cuts and poor technique while using machines
  • Not shutting off power to a tool when using hands to work on it
  • Operating machinery or vehicles under the influence of alcohol or drugs


Hand injuries are visible. Common problems are:

  • Pain
  • Ripped skin
  • Skin loss
  • Open wounds
  • Excessive bleeding
  • Exposed bone or tendons
  • Amputation of the hand or fingers
Severe Hand Trauma
hand trauma
© Nucleus Medical Media, Inc.


The doctor will examine the injury. Anesthesia may be given to block pain during the exam. Nerves and tendons of the hand will be tested.

Images will be taken to look for damage to the bones, nerves, tendons, and skin. This can be done with:


Emergency care will be needed. An IV will be started to give fluids and pain medicine.

The goals of treatment are to stop bleeding, manage pain, and repair damage. Options are:


Medicine will be given to ease pain and to block pain during medical care. Antibiotics may be given to lower the risk of infection.

People who have not had a recent tetanus vaccination may be given one. It can help the body find and attack the bacteria.

Wound Irrigation

The wound will be flushed with water. It will help to remove any debris that may be trapped in the wounds. This will help to prevent infection.

Hand Surgery

Less severe injury will be dressed and splinted. A surgical plan can be made later.

Surgery may be needed right away for severe injury. The goal is to repair as much damage as possible. They may save some hand function. Several surgeries are often needed for this type of injury.


Rehab can help a person get back movement in the hand. It can also help to make changes if there are some limits to hand movement. Rehab may include:

  • Physical therapy to improve movement
  • Occupational therapy to help with daily tasks and self care


To lower the risk of this problem:

  • Do not use machinery that is unfamiliar.
  • Follow all safety instructions when operating tools or machinery. Be especially careful when using snow blowers and lawn mowers.
  • Do not put fingers or hands near moving parts of machinery.


Hand Care—American Society for Surgery of the Hand 

OrthoInfo—American Academy of Orthopaedic Surgeons 


Canadian Orthopaedic Foundation 

The Canadian Society of Plastic Surgeons 


Fingertips injuries and amputations. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: Accessed August 19, 2021.

Mallet finger. EBSCO DynaMed website. Available at: Accessed August 19, 2021.

Snowblower safety. American Society for Surgery of the Hand Hand Care website. Available at: Accessed August 19, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board James Cornell, MD
  • Review Date: 07/2021
  • Update Date: 08/19/2021