Fractures of the hand and wrist.

The management of fractures from the industrial setting is very similar to treatment of fractures that occur elsewhere. However, the surgeon must constantly be on guard for any associated injuries that may be unique to the workplace, such as exposure to heat, cold, chemicals, or electricity. An accurate medical history of the patient and etiology of the injury are necessary. The overall emphasis must be a return to gainful employment. Treatment should be managed from the beginning. The initial action should be an aggressive approach, whether management is conservative or surgical, with a minimum of secondary procedures. An active role by the physician and his or her staff, and especially that of the hand therapist, should emphasize to the employer the advantages of returning the patient to work as soon as possible.