Emergency Hand Surgery

Many patients with hand injuries present to the GP or emergency department. We are however happy to see you on an urgent basis. Early treatment results in a better outcome. We will also monitor your condition with a hand therapist to try and maximise the outcome from your injury. Some injuries only involve one injured structure however others involve several. Always bring your x rays to your appointment. The risks and complications of hand surgery as a group is given on the hand injury instruction sheet.


( cuts to the hand) Lacerations in the hand or fingers are serious injuries and expert early treatment will improve the outcome. Lacerations can cause injury to nerves, tendons, blood vessels and joints. Sometimes when a  structure is damaged, it is not apparent at the time of injury and exploration is warranted to exclude injury or repair an injured structure.

Tendon injuries

A cut tendon can result in a loss of finger movement. Early intervention is important as it can be very difficult treating old tendon injuries. If there is tendon injury or a suspicion of tendon injury, seek early treatment. The operation involves finding the cut ends of the tendon and rejoining them with sutures. After this, depending on theinjury and repair, you will need a splint and period of hand therapy that ranges from 2-12 weeks.

Finger tip injuries

Fingers can be caught or crushed in doors or  work environments. If there is blood under the finger nail, this may represent a nail bed injury and accurate repair of this optimizes the outcome. An x ray is needed to check if the bones are fractured. If the skin is lost from the tip of the finger, then reconstructive surgery is needed to cover the end bone. It is not necessary to amputate the tip and every attempt is made to save the tip of the finger.

Finger fractures

Fractures can be isolated or occur with other injuries. The fracture may be compound ( that is open to the outside air via a cut in the skin) or sealed (closed ). The former requires more urgent attention to prevent infection in the bone. Fractures also may be associated with other injuries as above. Fractures may require either splints or fixation with an operation to heal the fracture.  Early opinion and treatment after injury with maximize  the outcome. Hand therapy and splinting is co ordinated with the hand therapist. You will need to come for reviews with x rays to monitor fracture healing.

Joint injuries and dislocations

Ligament injuries in the finger joints can become serious if not adequately treated. Many require splinting and hand therapy but some lead to long term problems of stiffness or instability. It is important for these to be assessed correctly to achieve the best possible outcome for you. Some injuries like a Gamekeepes thumb or volar plate repair, require operation. The operation involves opening the skin over the joint, finding the injured tendon and repairing this usually into the bone with a screw or pin. After the operation, the finger is splinted and then a period of hand therapy is needed to restore function.

Finger tip Amputations

These are the most common type of amputation. Sometimes the piece may be re attached but it often not possible. To avoid amputation of the tip, plastic surgeons have techniques using extra skin from the same finger or the adjacent finger to reconstruct the amputated tip. This restores the length sensation and functionality of the finger.

Finger Amputation

If a finger is amputated, then depending on the patients circumstance, it may or may not be replanted. Replantation is not always possible or practicle but the part should be brought with the patient to hospital for assessment. Dr Mahajani has performed successful replantations in Darwin.