Not another 4th of July report: uncommon blast injuries to the hand

Emergency Medicine Journal : EMJ
Matthias FrankGerrit Matthes

Abstract

Blast injuries to the hand are rare during peacetime and are mainly caused by fireworks. The injury patterns combine a variety of tissue destruction (laceration, dissemination, avulsion, blast, crush and burns). Emergency department staff play a key role in identifying the cause of injury, recognising the full extent of the lesion and referring patients for appropriate treatment. A review was undertaken to examine specificities in emergency department diagnosis and treatment of a separate subgroup of blast injuries. The diagnosis and treatment of patients admitted with work-related blast injuries of the hand were retrospectively reviewed. Demographic, clinical and diagnostic data were evaluated and treatment algorithms were analysed. Treatment algorithms of 14 patients suffering blast injuries of the hand due to a vole captive bolt device were analysed. The non-homogeneous injury pattern showed complex multistructural lesions. Relatively innocent-looking superficial wounds mask extensive deep tissue damage, the full extent of which could only be recognised after rigorous surgical exploration. All patients but one were treated by immediate surgery, debridement of tissue necrosis and lavage. A delay before surgery resulted in phl...Continue Reading

Citations

Jan 1, 2010·International Journal of Emergency Medicine·Bret A NicksR Gary Sibbald
Jun 25, 2014·Burns : Journal of the International Society for Burn Injuries·Xiaosheng HeYoudi Ni
Jul 16, 2013·Annales de chirurgie plastique et esthétique·K C AllahM Richard Kadio
Jun 12, 2013·Chirurgie de la main·V Pistré, J Rezzouk
Nov 21, 2008·Forensic Science International : Synergy·M FrankA Ekkernkamp
Sep 11, 2009·The Journal of Trauma·Matthias FrankGerrit Matthes
Sep 29, 2018·The Journal of Dermatological Treatment·Christina DaiAmor Khachemoune
Mar 19, 2019·Hand : Official Journal of the American Association for Hand Surgery·Ricardo OrtizKyle R Eberlin

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