Which structure is usually first repaired in hand injury?
**Core Concept**
Reconstructive surgery in hand injuries prioritizes restoring motor function and tactile sensation, often focusing on tendon and nerve repair. The order of repair is crucial to minimize complications and achieve optimal outcomes.
**Why the Correct Answer is Right**
The extensor tendons are typically repaired first in hand injuries. This is because extensor tendon repair allows for early mobilization of the wrist and fingers, which is essential for maintaining joint mobility and preventing stiffness. Early repair of extensor tendons also minimizes the risk of adhesions and promotes better tendon gliding. Furthermore, extensor tendon repair helps to maintain the integrity of the wrist and finger joints, which is critical for maintaining hand function.
**Why Each Wrong Option is Incorrect**
**Option A:** Flexor tendons are often repaired after extensor tendons because they are more prone to adhesions and require a longer period of immobilization. Repairing flexor tendons first can lead to stiffness and limited finger mobility.
**Option B:** Nerve repair is crucial in hand injuries, but it is not typically the first structure to be repaired. Nerve repair is often done simultaneously with tendon repair or may be delayed until after tendon repair is complete.
**Option C:** Bone fractures are essential to be stabilized before repairing soft tissues like tendons and nerves. Repairing soft tissues before stabilizing bone fractures can lead to poor outcomes and complications.
**Clinical Pearl / High-Yield Fact**
The "tendon-first" approach in hand injuries prioritizes restoring motor function and joint mobility, which is essential for maintaining hand function and preventing stiffness.
**Correct Answer:** C. Bone fractures are usually stabilized before repairing soft tissues like tendons and nerves.