The management of hand injuries forms an important part of the hospital accident and emergency service, and early recognition and informed management are essential for a favourable outcome (Frazier et al., 1978). In Edinburgh a routine system of hand management is well established and includes the training of casualty officers. In order to evaluate the effectiveness of the hand service in the Accident and Emergency Department, Royal Infirmary of Edinburgh, a prospective study was undertaken to compare the outcome of treatment of hand injury by a routine system with treatment over a similar period by more experienced registrars in hand surgery training posts (Hand Fellows).
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