When a hand is smashed either by two incoming sources or caught between one moving force and a non-moving force (e.g., car door), the outside layers of skin can be damaged. Cuts, bruises or ruptures in the skin can occur at the point of impact or stress. As the hand heals, repair begins in the epidermis by sealing any open wounds with body secretions called platelets, which stop the bleeding. White blood cells also gather at the source of injury to fight off or destroy any infection. Bruises heal on the outside first by moving damaged blood from the darkening areas. Once cuts and ruptures close, they cover over with thick tissue that protects the wounds but leaves scars.
Internal Injuries Heal
Once external injuries have healed, the internal counterparts must mend. White blood cells gather inside the smashed hand to remove any infection from spots of damage and bacteria. Red blood cells begin to rush past the spots of damage to bring oxygen and promote tissue, tendon and muscle repair. Depending on the extent of damage, the fascia (a layer of interconnective tissue) might also need to be repaired by the body.
Mobility and Strength Return
After both the external and internal injuries have healed, the smashed hand will need to be exercised to re-establish flexibility and mobility. As tissue heals, it can heal tighter and with more rigidity than before its injuries. Slowly straightening out and bending any injured fingers will establish the previous range of motion. Placing the hand flat on a table with the palm down will open up the extensions of the fingers and the flexibility of the inner hand and fascia. Making fists and using the smashed hand to pick up objects will exercise and restore the strength of the hand and its grip.
