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Multi-staged management of a mangled, exploded hand crush injury with long-term outcome: the critical link between surgery and therapy
  1. Spencer R Anderson1,
  2. Jacob A Vincent2 and
  3. Sunishka M Wimalawansa1
  1. 1Plastic and Reconstructive Surgery, Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA
  2. 2Division of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA
  1. Correspondence to Dr Spencer R Anderson; spencer.anderson{at}


A 38-year-old right-hand dominant man sustained a severe, work-related left-hand crushing injury. A multi-staged approach to salvage was employed in conjunction with aggressive hand therapy involvement for a successful, functional outcome. Now at approximately 5 years postinjury, the patient can perform daily activities, coaches sports and has returned to and maintained his full-time work position. Mangled, severe hand crush injuries warrant immediate treatment to debride non-salvageable tissues, stabilise and revascularise the hand in an effort to maximise reconstructive potential and functional capacity. It is critical to recognise that these cases require multiple stages of operative reconstruction with direct and ongoing involvement of hand therapy and pending degree of injury, rehabilitation often lasting months to years.

  • Plastic and reconstructive surgery
  • Orthopaedics
  • Physiotherapy (rehabilitation)
  • Trauma

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  • Contributors All authors have contributed to the manuscript in the following way: SRA: Operative intervention, chart review, literature review, initial draft review and final draft submission. JAV: Operative intervention, chart review and initial draft review. SMW: Initiation of study, preoperative workup, operative intervention, postoperative care and draft review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.