A. How to deal with first aid after hand trauma? The first aid treatment of hand trauma includes hemostasis, wound dressing and local fixation. 1.Hemostasis Local pressure bandage is the easiest and effective method to stop bleeding in hand trauma, even if the ulnar or radial artery is injured, pressure bandage can generally achieve the purpose of hemostasis. Tourniquets are only used to stop bleeding due to a few large vessel injuries. Apply a balloon tourniquet tied to the upper 1/3 of the upper arm, apply a good liner, record the time, and quickly transfer. The pressure should be controlled at 33.3~40kPa (250~300mmHg), and if the time exceeds 1 hour, it should be relaxed for 5~10 minutes before adding pressure to avoid causing ischemic muscle spasm or necrosis of the limb. When relaxing the tourniquet, pressure should be applied to the injured area to reduce bleeding. 2.Wound dressing Dress the wound with a sterile dressing or clean cloth to prevent further contamination of the wound, and do not apply potions or sprinkle anti-inflammatory drugs inside the wound. 3.Local fixation During the transfer process, regardless of whether the injured hand has obvious fractures, should be properly fixed to reduce the patient’s pain and further aggravate the tissue damage. The fixation equipment can be taken from the local area and used in accordance with the local conditions, such as wooden boards, bamboo sheets, cardboard, etc. The range of fixation should reach above the wrist joint. 4. Quickly transfer to hospital for further treatment. Second, how to correctly place the affected limb after surgery? 1.If the patient is lying down, the affected limb should be elevated 20-30° to promote venous and lymphatic reflux and reduce swelling. The injured hand should generally be kept in a functional position, i.e. dorsal wrist extension, metacarpophalangeal joint flexion, interphalangeal joint slightly flexed and thumb to palm position. For patients with vascular anastomosis, absolute bed rest for 7-10 days after surgery is prohibited, and the affected side is prohibited to ensure good blood circulation to the affected finger to prevent vascular spasm and thrombosis. 2.Patients sit or stand and walk with the affected limb hanging in front of the chest, not just hanging down or flinging with walking, which affects the venous blood and lymphatic fluid reflux. 3, as far as possible, as soon as the condition allows, move the affected limb, can use physical therapy, microwave light baking, to help reduce edema. Third, functional exercise after hand trauma 1, skin injury direct suture postoperative exercise Postoperative pain, swelling can be reduced to start functional exercise, practice clenching fist, flexion and extension of the metacarpophalangeal joint, interphalangeal joint, in order not to cause significant pain, excessive wound tension, flexion and extension of the wrist, rotation of the wrist joint, to prevent joint stiffness; wound stitching, practice clenching fist, flexion and extension of the fingers, internal abduction and abduction activities, to maintain normal muscle strength, so that The functional activities of the joints of the hand should be restored to normal as soon as possible. 2.Postoperative exercise of skin defect repair with tipped flap Postoperative exercise of skin defect repair with tipped flap needs to be fixed for 3 weeks, so try to expose the healthy finger to avoid affecting postoperative exercise and causing disuse dysfunction. On the second day after surgery, the passive activities of the healthy finger can be carried out with a small amplitude, so as not to cause pain. 1 week later, the maximum active flexion and extension of the healthy finger, exercise, pay attention not to pull the flap; to be local inflammation, edema reduction can do the flexion and extension of the affected finger, the amplitude of action slowly increase, so as not to cause local pain; after the severed tip, the healthy finger to do the largest flexion and extension activities, the affected finger passive, active activities After the severed tip, the healthy finger was flexed and extended to the maximum extent, and the affected finger was moved passively and actively. After the removal of the suture, further increase the range and intensity of activities, such as fist clenching, finger extension, holding a rubber band in the hand and other activities. Rub and turn the stone ball or walnut to exercise the various functions of the fingers as well as coordination movements to restore the flexibility of the hand as soon as possible. 3.Functional exercise for hand fracture and joint dislocation After the hand fracture and joint dislocation are reset, generally use plaster and brace to fix the functional position for 3 to 4 weeks. During the fixation period, active flexion and extension activities of the healthy finger, passive activities of the affected finger of the affected hand, assisted activities of the affected finger with the healthy finger, flexion and extension of the joint, the amount of activity is limited to not cause re-injury. After the pain disappears, change the passive activity to active activity, and at the same time do the wrist flexion and extension rotation activities that do not affect the fixation; after removing the external fixation, instruct the patient to do slow active flexion and extension activities, and strive to reach the maximum each time, if there is a joint movement disorder, use the healthy finger to assist the activity, and the flexion and extension amplitude should be greater than the amplitude of the active activity; patients who fail to function correctly and have joint stiffness and muscle atrophy after the fracture healing, can also can be exercised according to the above method. 4, hand tendon injury repair after functional exercise tendon release surgery can generally be removed 24 hours after the dressing, start functional exercise, active flexion and extension activities, 3 to 5 times a day, each flexion and extension about 25 times, while not ignoring the activities of the healthy finger. When the active activity of the affected finger is painless and the range of activity is normal, resistance exercise can be started and practiced more every day until the strength of the range of activity of the affected finger is comparable to that of the normal finger; after tendon repair surgery, plaster rests and braces are generally applied for 3 to 4 weeks. First of all, move the unfixed joint, and do not move the affected finger within 3 weeks after surgery, because the premature tendon activity can destroy the newly established blood supply between tendon sheath and tendon, resulting in ischemic degeneration and necrosis of the transplanted repaired tendon. After 3 weeks, the external fixation should be lifted and passive and active activities of the affected finger should be carried out until the flexion and extension of the affected finger is normal.