Managing Mutilating Hand Injuries

•Management of mutilating injuries is complex and should be based on clear understanding of principles of wound management, fracture fixation, and soft-tissue reconstruction.•The surgeon must be able to anticipate the effects of the trauma and set clear goals of reconstruction directly from the first surgery.•Debridement, bony stabilization, revascularization, and soft-tissue cover should be achieved in the primary surgery. Nerve and tendon...