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Nerve Injuries and Lacerations of the Hand
Understanding cut, stretch and crush injuries to the nerves of the hand, and why prompt assessment matters.
What are Nerve Injuries and Lacerations of the Hand?
A nerve injury is a cut, stretch or crush injury to one of the nerves that carry sensation and movement signals to and from the hand. Most nerve injuries are caused by a cut (laceration), but they can also occur from a stretch or crush injury without any wound at all.
Nerve Injuries and Lacerations of the Hand at a glance
What is it?
A cut, stretch or crush injury to a nerve supplying sensation and movement to the hand
Common symptoms
Numbness in the area supplied by the nerve, and weakness of the muscles it controls
Who it affects
Anyone with a cut to the hand, wrist or forearm, or a significant crush or stretch injury
Is it serious?
Nerves have limited ability to heal, so a complete injury generally needs surgical repair
Treatment options
Surgical repair for complete injuries, or observation for some partial injuries
First step
Prompt assessment to determine which nerve is involved and whether repair is needed
Symptoms and how Nerve Injuries and Lacerations of the Hand present
The main symptoms are numbness or altered sensation in the fingers or hand, and weakness of the specific muscles supplied by the injured nerve. There is often a wound if the injury was caused by a cut, along with pain.
Causes and risk factors for Nerve Injuries and Lacerations of the Hand
- Cuts from knives, glass or machinery
- Crush injuries
- Stretch injuries, such as from a dislocation or traction injury
- Work-related injuries
How are Nerve Injuries and Lacerations of the Hand diagnosed?
Diagnosis is based on examination, testing sensation and (where applicable) muscle function in the area supplied by each nerve, along with assessment of any wound for other injured structures such as tendons or blood vessels.
Treatment options for Nerve Injuries and Lacerations of the Hand
Complete nerve lacerations are usually repaired surgically, ideally soon after the injury, often using a microscope to align the delicate nerve fibres as accurately as possible.
Recovery of sensation and movement after a nerve repair happens gradually as the nerve regrows, and the pace and extent of this varies between patients.
Some partial or stretch-type nerve injuries can recover without surgery and are monitored closely instead. Sometimes it is only after the nerve has been explored and visualised at the time of surgery that it can be known whether there was, or was not, a cut to the nerve to cause the altered sensation or numbness.
When to see a hand surgeon about Nerve Injuries and Lacerations of the Hand
Any cut to the hand, wrist or forearm associated with numbness or weakness should be assessed urgently, as timely repair gives the best chance of a good recovery.
What to expect at your Nerve Injuries and Lacerations of the Hand appointment
At assessment, Dr Tomlinson or her team will examine your wound, sensation and (where applicable) muscle function, and arrange surgery promptly if a repair is needed.
Related conditions and treatments
A cut that injures a nerve can also injure a nearby tendon, so nerve injuries are often assessed alongside hand and finger tendon injuries. This is different from nerve compression conditions such as carpal tunnel syndrome and ulnar nerve compression at the wrist, which develop gradually rather than from a cut.