Coastal Plastic Surgery & Medi Spa — Erina NSW Hand Injuries
Acute hand injuries require prompt expert assessment and treatment to prevent permanent loss of function. Our specialist plastic surgeons are trained in all aspects of hand injury surgery — from tendon and nerve repair to fracture fixation and replantation.
Why prompt treatment matters
Acute hand injuries may involve both the soft tissues of the hand as well as its bony structures. The hand is one of the most complex and functionally important parts of the body — even seemingly minor injuries can result in permanent loss of function if not assessed and treated promptly by an experienced hand surgeon.
Soft tissue injuries include damage to tendons, ligaments, nerves, and blood vessels. Bony injuries include fractures and dislocations of the fingers, hand, and wrist. Many hand injuries involve a combination of these structures, and accurate assessment is essential to determine the most appropriate surgical approach.
Assoc. Prof. Gazi Hussain routinely performs acute hand injury surgery and has been trained in all elements of hand surgery. Early referral to a specialist ensures the best possible functional outcome.
Go directly to your nearest emergency department if your hand injury involves: significant bleeding that cannot be controlled, a completely or partially severed finger or hand, an open fracture (bone visible through skin), loss of feeling or movement, or a crush injury. Time is critical for replantation and vascular repair — do not delay.
Tendon and nerve repairs have significantly better outcomes when performed promptly after injury. Delayed repair can result in tendon retraction, scarring, and nerve degeneration that makes repair more difficult and recovery less complete. If you have sustained a significant hand injury, early specialist assessment is strongly recommended.
Injuries we treat
Our specialist plastic surgeons assess and treat the full range of acute and sub-acute hand injuries, from straightforward lacerations to complex multi-structure injuries.
Flexor Tendon Injuries
Injuries to the flexor tendons — which run along the palm side of the fingers — cause inability to bend the finger. If left unrepaired, permanent loss of finger flexion and abnormal finger posture result. Prompt surgical repair under magnification gives the best functional outcome.
Extensor Tendon Injuries
Injuries to the extensor tendons — which run along the back of the hand and fingers — cause inability to straighten the finger or wrist. Extensor tendon injuries may result from lacerations, crush injuries, or avulsion. Some can be managed with splinting, others require surgical repair.
Nerve Injuries
Digital and hand nerve injuries cause partial or complete loss of sensation. As touch and temperature sensation are critical for hand function, traumatic nerve injuries should be repaired surgically to optimise the return of feeling. The earlier repair is performed, the better the outcome.
Vascular Injuries
Injuries to the arteries and veins of the hand and fingers can threaten the viability of the digit or hand. Vascular injuries require microsurgical repair to restore blood flow and prevent tissue loss. This may form part of a replantation procedure.
Fractures of the Hand & Fingers
Hand fractures may be managed with splinting alone, or require surgical fixation with K-wires (surgical pins), plates, or screws depending on the fracture type and displacement. Assessment includes clinical examination and X-ray. Accurate reduction and stable fixation allow earlier mobilisation and better functional recovery.
Dislocations & Ligament Injuries
Finger and wrist dislocations and ligament injuries can result in joint instability and long-term pain if not properly managed. Some require surgical repair of the ligament, while others are managed with immobilisation and hand therapy.
Lacerations & Soft Tissue Injuries
Complex lacerations involving deeper structures — including tendons, nerves, and vessels — require careful exploration and repair under appropriate anaesthetic and magnification. Simple skin lacerations may be managed with suture repair alone.
Amputations & Replantation
Partial or complete amputation of a finger or hand may be suitable for replantation (surgical reattachment) using microsurgery. Outcomes depend on the level and mechanism of injury, ischaemia time, and patient factors. This is a time-critical emergency procedure.
Skin Loss & Degloving
Crush and degloving injuries resulting in skin loss require reconstructive surgery to provide soft tissue coverage. Options include skin grafting, local flaps, and in some cases free tissue transfer depending on the extent of the defect.
Hand Burns
Hand burns require specialist management to prevent contracture and preserve function. Deep partial thickness and full thickness burns often require early excision and skin grafting, followed by hand therapy and splinting to optimise range of motion.
What to do after a hand injury
The steps taken in the first hours after a significant hand injury can have a major impact on the outcome. Here is what to do while seeking medical attention.
Depending on the fracture type and displacement, fixation may be performed with K-wires (flexible surgical pins inserted percutaneously), or with plates and screws via open reduction and internal fixation (ORIF). The choice of procedure is determined by the fracture pattern, assessed clinically and radiologically (X-ray or CT scan).
Stable fixation allows earlier mobilisation with hand therapy, which is important for achieving the best functional outcome.
For work-related hand injuries, it is important that the injury is properly documented from the outset. Our practice can assist with medical reports and documentation as required. Please inform our rooms at the time of booking if your injury is work-related or involves a third party claim.
Recovery & hand therapy
Surgical repair of hand injuries is only one component of recovery. Hand therapy — provided by a specialised hand therapist — is essential following surgery to restore strength, range of motion, and function.
Following tendon repair, a carefully controlled rehabilitation programme is commenced to protect the repair while encouraging early movement. Protocols have evolved significantly and most modern tendon repairs allow gentle mobilisation within days of surgery under the guidance of a hand therapist.
Following nerve repair, sensation recovery is a gradual process that takes months to years. Sensory re-education with a hand therapist helps the brain adapt to recovering nerve signals and improves functional outcome.
Following fracture fixation, hand therapy assists with oedema management, scar treatment, splinting, and progressive range of motion and strengthening exercises tailored to your specific injury and repair.
Our practice works closely with hand therapists on the Central Coast and in Sydney. A referral to a hand therapist will typically be arranged at the time of your surgery or at your first post-operative review. Compliance with hand therapy is one of the most important factors in achieving a good functional outcome after hand injury surgery.
The timeline for return to work and normal activities varies significantly depending on the nature and severity of the injury and the type of work involved. Your surgeon will provide specific guidance on activity restrictions and return to work planning at each stage of your recovery.
Our specialist plastic surgeons
Hand injury surgery at Coastal Plastic Surgery is performed by our FRACS-qualified specialist plastic surgeons, who have training and experience in all aspects of acute and elective hand surgery.
Hand surgery specialist
Common questions about hand injuries
Flexor tendon injuries are best repaired within the first few days of injury — ideally within 24 to 72 hours. After this window, tendon ends retract and scar tissue begins to form, making repair more technically difficult and outcomes less predictable. Extensor tendon injuries are generally more forgiving, but early repair still gives the best results. If you suspect a tendon injury, seek specialist assessment promptly.
Many patients regain excellent function after tendon repair, particularly when surgery is performed promptly and hand therapy rehabilitation is completed diligently. However, outcomes depend on the zone and type of injury, the quality of the repair, and the patient's compliance with rehabilitation. Your surgeon will discuss realistic expectations for your specific injury at consultation.
Yes — numbness after a hand or finger laceration strongly suggests a nerve injury. Nerves do not heal on their own once divided; they require surgical repair under magnification to restore sensation. The sooner a divided nerve is repaired, the better the outcome. You should seek specialist assessment urgently — do not wait and see if sensation returns on its own after a laceration.
Not all hand fractures require surgical fixation. Stable, undisplaced fractures can often be managed with splinting and hand therapy alone. However, displaced or unstable fractures, fractures involving the joint surface (intra-articular), and open fractures typically require surgical fixation to restore alignment and allow early mobilisation. The appropriate management is determined by the fracture type on X-ray and clinical examination.
Not all amputated fingers or hands are suitable for replantation. Factors including the level of amputation, mechanism of injury (clean cut vs crush or avulsion), condition of the amputated part, ischaemia time, and patient health all influence whether replantation is technically feasible and likely to result in a functional outcome. The decision is made on a case-by-case basis by the treating surgeon. Bringing the amputated part to hospital, preserved correctly on ice, always maximises the possibility.
Hand injury surgery is a reconstructive procedure and Medicare item numbers apply. Applicable rebates will be shown on your quote following consultation. If your injury is work-related, it may be covered under WorkCover or your employer's workers compensation insurance. If it resulted from a motor vehicle accident, it may be covered by the CTP insurer. Please inform our rooms at the time of booking if a third party claim is involved.
Concerned about a hand injury?
Contact Coastal Plastic Surgery to arrange an urgent or routine consultation with our specialist plastic surgeons for assessment and management of your hand injury.