Hand Trauma

Hand Trauma

Repairing Crushed or Severed Fingers / Thumb

Hand injuries are among the most common workplace incidents in Australia, with around 8,400 Australians hospitalised each year due to hand-related trauma. The most severe cases often involve crushed or severed thumbs and fingers, which can have a major impact on function, mobility, and quality of life.

At the Adelaide Shoulder & Upper Limb Clinic, Dr Oscar Brumby-Rendell specialises in advanced surgical treatment for severe hand trauma. Using minimally invasive techniques wherever possible, his goal is to reduce pain, restore movement, and maximise long-term hand function.

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Frequently Asked Questions

What should I do immediately after a severe hand injury?

For serious hand injuries, such as a crush, deep cut, or amputation, apply clean pressure to stop bleeding, immobilise the hand, and seek emergency medical care. Keeping the injured area elevated can help reduce swelling until treatment is available.

Can a completely severed finger or thumb always be reattached?

How should a severed finger or thumb be preserved before surgery?

Will I regain full function after a hand trauma surgery?

How long does it take to return to work after a serious hand injury?

Are there long-term risks after a major hand injury?

Surgical Repair for Crushed Fingers or Thumbs

Hand and wrist conditions are treated by Oscar Brumby-Rendell through various surgeries.

When fingers or thumbs sustain significant damage, such as fractures, severe lacerations, or injuries to nerves, arteries, or tendons, surgical repair is often necessary.
The type and severity of the injury determine the surgical approach, and in most serious cases, surgery should ideally be performed within 24 hours to achieve the best possible results.

Replantation – Reattaching Severed Fingers or Thumbs

Restoration and reattachment of the hand are the primary aims for replantation surgery

In cases of complete amputation, replantation surgery aims to restore both appearance and function by reattaching the severed part to its correct anatomical position.
This complex procedure involves reconnecting bones, tendons, muscles, blood vessels, and nerves.

However, replantation may not be possible if the injury involves severe crushing, in which case the affected part may need to be shortened or reconstructed using alternative surgical techniques.

What Happens During Hand Repair Surgery?

A typical hand repair procedure may involve:

Removing damaged or non-viable tissue
Repairing or reconstructing tendons, arteries, and nerves
Shortening bone ends before reattachment
Using skin grafts or tissue flaps from other body parts to protect exposed structures

The goal is to restore circulation, movement, and sensation while minimising scarring and long-term complications.

Dr Oscar Brumby-Rendell | ASULC | Adelaide Shoulder & Upper Limb Clinic

Recovery After Hand Trauma Surgery

Injury severity, surgery type and motor and sensory nerve regrowth rate dictate the recovery length and requirements.

Recovery time depends on:

Injury severity
Surgical complexity
Rate of nerve regeneration

Sensory nerves transmit messages about pressure, temperature, and pain to the brain, while motor nerves control movement. Nerves typically regrow at about 2 cm per month, so the distance from the injury to the target muscle or skin area largely determines the recovery timeline.

Rehabilitation After Hand or Finger Surgery

Even after the surgical wound has healed, rehabilitation is critical.
Dr Brumby-Rendell provides each patient with a custom exercise program to:

Strengthen and protect repaired tendons
Maintain flexibility
Reduce scar tissue formation

Splints, braces, and physiotherapy may also be used to optimise recovery.

Dr Oscar Brumby-Rendell | ASULC | Adelaide Shoulder & Upper Limb Clinic | Hand and Wrist Surgery

Returning to work after a hand or finger repair

A well-structured return-to-work plan can help you recover faster and regain independence.
In some cases, you may begin with lighter duties before resuming your original role. Regular communication between you, your employer, WorkCover, and Dr Brumby-Rendell ensures a safe, timely, and positive return to work.

If you cannot immediately return to your normal duties, Return-To-Work programs can help you transition back to employment safely. This may involve:

Modifying your work tasks
Adjusting work hours or days
Gradually increasing workload as your hand strengthens

Dr Brumby-Rendell works closely with you, your employer, and rehabilitation specialists to create a suitable duties plan tailored to your capabilities and recovery stage.

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Frequently Asked Questions

What complications are common after hand trauma surgery, and how can they be minimised?

Complications after hand trauma repair can include infection, nerve or vessel injury, wound healing problems, and scar formation. Also, stiffness of joints and tendon adhesions are frequent.

Minimising risks involves early and appropriate surgical technique, good wound care, controlling swelling, and starting motion/rehab as soon as safely possible. Also, ensuring good vascular supply and careful handling of nerves and soft tissue helps.

How long does functional recovery typically take after a severe hand injury, and what does “full recovery” mean?

Recovery from a severe hand injury is a gradual process that often spans many months. One longitudinal study of major hand trauma patients showed meaningful improvements in function, pain, daily satisfaction, and physical quality of life over 3, 6, and 12 months.

“Full recovery” often means getting back enough strength, range of motion, and dexterity to perform daily tasks and work. It does not always mean perfect return to pre-injury levels, especially in very complex injuries.

What role does psychological resilience or mindset play in outcomes after hand trauma?

The concept of sense of coherence (how people perceive their life as understandable, manageable, meaningful) has been shown to predict better outcomes after severe hand injury.

Patients with higher sense of coherence tend to report better quality of life, less disability, and greater satisfaction in daily activities.

Mental health, coping skills, sleep, pain management, and social support also have significant influence on recovery speed and patient satisfaction.

When is group therapy useful versus individual rehab for hand trauma?

Group-based rehabilitation programmes have been shown to benefit many patients with complex hand injuries. In one “group intervention” audit, 19 of 20 patients improved hand function (measured by DASH) following group therapy.

However, individuals with complications like Complex Regional Pain Syndrome (CRPS) or more severe nerve damage may benefit more from individualized, tailored therapy rather than group settings.

How is cold sensitivity after hand trauma managed, especially when it persists long term?

Cold sensitivity is a common complaint after hand injury and can persist for many months. In studies, it often shows little improvement over time, particularly in patients with nerve injury.

Management includes protective strategies (gloves, warmth), pacing cold exposure, desensitization techniques (gradual exposure to cooler temperatures), and sometimes occupational therapy to modify how tasks are performed.

What outcome measures or tools help track recovery, and why are they important?

Using validated outcome tools (“PROMs” – Patient Reported Outcome Measures) helps both patient and clinician see progress over time, set realistic goals, and make decisions about next steps. For hand trauma, tools like DASH, QuickDASH, Michigan Hand Outcomes Questionnaire (MHQ), and other hand-/wrist-specific functional scales are commonly used.

Regular measurement (e.g. at 3, 6, 12 months) helps pick up when recovery is slower than expected, or when additional interventions (therapy, surgical revision) may be needed.

How Dr Oscar Brumby-Rendell can help

Dr Oscar Brumby-Rendell provides consultation and treatment in Adelaide for various hand and wrist conditions.

Dr Oscar Brumby-Rendell has extensive upper limb experience in areas of diagnosis, treatment and surgery. In your consultation, Dr Oscar Brumby-Rendell will develop a treatment plan with you to ensure the best possible results for your hand or wrist condition.

Click for more information regarding shoulder, hand, wrist, and elbow conditions which Dr Oscar Brumby-Rendell has experience in treating.

After Surgery Considerations (PDF)

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