Hand Injury: tic tac toe classification

Mutilating hand injuries may be classified by this scheme of Orientation, Wound type and Zone of injury:

Orientation           Wound Subtype
I Dorsal A Soft Tissue Loss
II Palmar B Bony Loss
III Ulnar C Combined Tissue Loss
IV Radial 1 Vascularized
V Transverse 2 Devascularized
VI Degloving
VII Combined

Zone of Injury

Zone Radial Central Ulnar
Distal I
Thumb P1, P2
II
Index, Middle P1, P2, P3
III
Ring, Small P1, P2, P3
Central IV
Thumb Metacarpal
V
Index, Middle Metacarpal
VI
Ring, Small Metacarpal
Proximal VII
Scaphoid, Trapezium, Trapezoid
VIII
Capitate, Lunate
IX
Hamate, Triquetrum, Pisiform

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