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A National Audit of Current Practice in Managing Open Flexor Tendon Injuries and Open Hand Fractures

The RSTN is collaborating with the BSSH to deliver a national audit of the current management of two key areas of hand trauma.

Registration open now, data collection starts 1st July 2015.


Hand fractures and flexor tendon injuries are common. There are no national guidelines for the management of either of these injuries. The BSSH have created draft ‘Handstands’ for both flexor tendon injuries and open fractures of the hand (see below for files).


To provide baseline audit information on current key performance indicators on the management of these injuries. This will allow future changes in practice to be re-audited following publication of national guidelines.


Prospective audit recruiting all patients presenting with an open hand fracture or an open flexor tendon injury over a 3 month period.

Outcome data collected at 3 months.

Central data collection using the REDCap encrypted database

Audit needs to be registered with local Clinical Audit Department. Caldicott approval not required as information is recorded in the REDCap database without patient identifiable information.

Inclusion criteria

Any acute open flexor tendon injury involving zones 1 – 4 (injuries can be single or multiple)

Any acute open hand fracture (injuries can be single or multiple)

Exclusion criteria

Open tuft fracture

Closed flexor tendon injuries ie Jersey Finger


Data will be collated and used to assess current standards of management of these two injuries using key markers. This data will help to guide the development of national standards of care in hand trauma produced by the BSSH.

National guidelines will be introduced to optimise patient management and outcome, guided by the results of this audit.


We are keen to encourage as many Units to participate as possible. Therefore anyone who is involved in the recruitment process and logs 5 patients into the database will be eligible for collaborative author status (Pubmed citation) on any publications and presentations.

How do I get involved?

  1. Contact to register your interest and you will be provided with login instructions for the REDCap database.
  2. Identify a consultant from your local hand trauma team who will sponsor the project for the audit registration.
  3. Register the audit with your local Clinical Audit Department using the information in the documents listed below:
    Draft Handstand 1 Flexor Tendon Injuries Final

    Draft Handstands 2 Open Hand Fractures Final

Data Collection Tools

BSSH Flexor Data Collection v3

BSSH Fracture Data Collection v3