Hand trauma and assessment unit

If you have been referred from A&E, you have been asked to attend the clinic for review of your injury. You will be seen in order of clinical priority.

Please bring any prescriptions for medication you are currently taking.

Following an assessment with a plastic surgeon, a plan for your treatment will be discussed with you. This may include management with dressings, hand therapy or an operation.

If an operation is needed, you may be asked to return on another day for your surgery. This length of time you will need to wait will depend on the severity of your injury, the type of anaesthetic needed and your medical history.  

However, we can experience high numbers of referrals and due to the emergency nature of the service, your operation may be rescheduled for a different day.

We provide specialist care for both adults and children with both non-surgical or surgical conditions of the hand and forearm.

Care is carried out by a specialist hand therapist who are registered occupational therapists and physiotherapists. They will also work closely with plastic and orthopaedic surgeons.

You will receive an individual assessment and treatment session.  Your therapist will have detailed knowledge and understanding of your surgery or condition and will plan with you a treatment programme.  This may include various evidence-based assessments.  Treatments may include splinting, paraffin wax, electrotherapy, exercises, joint mobilisation and rehabilitation to support your return to work and leisure activities. 

If you are due to visit us for a pre-assessment appointment, please bring any prescriptions for medication you are currently taking.

You will see a nurse who will take a full medical history.

You may need to have tests while at the hospital, such as blood tests or and ECG. In some cases, you may also need to see an anaesthetist.

Due to this, please allow up to three hours to be at the hospital when you come for your appointment.

Please bring with you any notes or x-rays that you are given by A&E, any medication you normally take along with any antibiotics or pain killers you are taking currently.

We ask that one person escort you to the unit, as you may not be insured to drive with a hand injury, or after having surgery.

If your treatment includes surgery, you can have this without the need to in overnight but it depends on your injury. It’s always a good idea to bring a small overnight bag just in case you do need admission.

Due to the nature of emergency trauma theatre, there may be a wait of a few days before your surgery can be completed. This is usually carried out within one and seven days. However, surgery can still be postponed at very short notice if there is a patient who needs more urgent surgery. We apologise for any concerns this may cause and will try to manage each case individually.

If you are given any medication, please continue to take them according to the instructions. Pain killers such as paracetamol and ibuprofen can be taken as well if they are needed.

Before your operation

You may be asked to go home and return later date for your operation. You may continue to eat and drink until the day of your operation when you will be advised to remain ‘nil by mouth’ from a specified time.

At times there maybe unexpected space in theatre, so you may be asked to come in for your operation at short notice.

Your bandage should be kept clean and dry at all times.

To reduce swelling and pain, you should keep your hand above heart level, preferably at shoulder level.

At night your arm should be raised on a couple of pillows.

Remove all jewellery from the affected hand as swelling may cause constriction, ending in the jewellery being cut off if it cannot be removed.

Contact the hand trauma unit or the emergency department if you have any of the following:

• your fingers appear pale or cool
• your fingers have pins and needles that start after you get home
• you can no sleep due to pain, even though you have taken pain killers
• your bandage becomes wet, or dirty
• you have smelly discharge from your wound
• bleeding which does not stop. To try and stop the bleeding by:
  • raising your hand above your head
  • pressing firmly on the area for at least 5 minutes.

We provide specialist care for both adults and children with both non-surgical or surgical conditions of the hand and forearm. Care is carried out by a specialist hand therapist and will work closely with plastic and orthopaedic surgeons.  

Patients will receive individual assessments and treatment sessions.  

Your therapist will have detailed knowledge and understanding of your surgery or condition and will plan with you a treatment programme.  This may include various evidence-based assessments.  Treatments may include splinting, paraffin wax, electrotherapy, exercises, joint mobilisation and rehabilitation to support your return to work and leisure activities.