A 3-Phase Approach for the Management of Upper Extremity Electrical Injuries

Upper extremity electrical injuries present with unique pathophysiologic considerations due to the differing mechanisms of injury produced by the electromagnetic field. The initial phase of treatment consists of recognition of other life-threatening injuries, stabilization of patients, and multisystem resuscitation. The second phase of treatment consists of excising devitalized tissue, appropriate wound care to prevent delayed infection, providing temporary and definitive coverage over vital structures, and preventing contracture and joint stiffness via aggressive therapy. The final phase of treatment consists of sensorimotor functional reconstruction via nerve grafting and tendon transfers available based on patients' deficits and available redundant sources.