Cracker Burst Injuries of Hand

Senthil Kumaran, S (2007) Cracker Burst Injuries of Hand. Masters thesis, Stanley Medical College, Chennai.

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Abstract

AIM: To analyze and classify the pattern of Cracker burst injuries of Hand, treatment options available and outcomes. MATERIALS AND METHODS: 70 consecutive patients presented to the emergency hand injury service of our department with the history of accidental cracker burst injury to their hand or hands from January 2005 to January 2007 were taken for analysis. A proforma was prepared and detailed history was obtained, thorough general examination were performed before the assessment of the hand wounds, then appropriate investigations were performed, patients were reviewed after the investigations and appropriate treatments were offered primarily. Total number of patients; 70. Age group; from 3 years to 80 years. Mean age; 23 years. Children (less than 13 years); 14. Male: female ratio; 64:6. Type of fire cracker used; factory made-47. Country made-23. RESULTS: In our series, out of the 15 patients of grade 1 injuries 9 patients were treated with primary skin suturing, 3 required SSG and another 3 required CFF from the adjacent finger. Cross finger flaps were divided after 14 days, on the average required 6 to8 dressing changes before complete wound healing, they were able to return to work at an average of 5 weeks. Follow up of these patients showed complete recovery of function and no deformities. CONCLUSIONS: The grading system proposed in this study is useful in planning the treatment and predicting the prognosis. The outcome of the hand injury is depends upon the severity of the initial injury. We are comfortable with the Groin flap for providing sufficient skin cover of the hand following the cracker burst injuries. Nerve injuries are severely detrimental to the final outcome and end to side nerve repair offers possible solution the problem. Thumb is the worst affected part of the hand following the cracker burst injury and it’s reconstruction remains a challenge for the surgeon. The continuous availability of crackers through out the year in the markets is one of the reason for more number of injuries. Social customs of bursting crackers during the temple festivals and funerals provide the opportunity for the accidents to occur. Availability of high intensity fire crackers and crudely produced country made crackers used in the villages are reasons for the very severe injuries. The unsafely practice of bursting crackers in the hand is the major culprit for the entire problem. Cracker burst injury to hand can lead to major hypovolemic shock, as shown in study 10% of the patients required blood transfusions during resuscitation Prevention of these injuries can be done by formulation and strict enforcement for legislature to follow the safety precautions and banning the production of high intensity fire crackers. Thumb and thumb web injury is one of the most important factor in predicting the prognosis.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Cracker Burst Injuries ; Hand.
Subjects: MEDICAL > Plastic and Reconstructive Surgery
Depositing User: Kambaraman B
Date Deposited: 12 Oct 2017 01:49
Last Modified: 12 Oct 2017 01:49
URI: http://repository-tnmgrmu.ac.in/id/eprint/3506

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