The underestimation of a glass injury to the hand.

This study sought to ascertain the differences between what is found on an orthopedic preoperative examination of a glass injury to the hand and the actual intraoperative deficiencies noted in the operating room. The cases of 34 patients who presented to our institution for a shattered glass laceration to the hand, forearm, or wrist between 1998 and 2001 were reviewed. The preoperative examination significantly underestimated the amount of damage to tendons, arteries and nerves. The most frequent injury pattern was the flexor digitorum superficialis (34/103 = 33%), the radial artery (7/18 = 39%), and the superficial branch of the radial nerve (7/32 = 22%). A glass injury to the hand can be a deceivingly debilitating and significant injury. The preoperative examination, even when specifically evaluating for deficiencies, significantly underestimates the extent of damage. If glass is implicated as a causative agent, careful orthopedic evaluation and surgical management should be considered even in light of a normal preoperative examination.