Hand Trauma Injury to any part of the hand is reconstructed followed by close follow ups to achieve normal function. Any loss is replaced with “like tissue”. Secondary reconstruction is performed in patients with delayed presentation.

The child is assesssed from the age of 6 months and surgeries are performed form the age of 6 months onwards, assisted with physiotherapy; the ultimate aim is to provide primarily a functional hand and it should look normal as well as far as possible. Prosthesis is also arranged for cosmetic needs

These are initially managed conservatively with physiotherapy and exercises. Surgery may be taken up as a last resort to achieve complete resolution of the problem.

Complex hand/ finger detachment has to be managed on an urgent basis as it needs to be reattached using microsurgical skills. It requires close followup and regular physiotherapy sessions to achieve a functional hand/ finger with secondary operations if need be.

Nerve Surgeries Various presentations in the form of loss of function/sensation of hand, forearm areas are managed by the surgeries. Traumatic loss is treated with Nerve Grafts using microscope.

insteda of ' injury to the nerves at the level of spine and neck which supply the hand,' it should be 'injury to the nerves at the level of plexusi.e neck region which leads to complete or partial paralysis of hand, arm or forearm,'