Citation

Mohan A, Nolan GS, Jain A. BMJ Case Rep. 2019; 12(10): e19-231804.

Affiliation

Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Botnar Research Centre Institute of Musculoskeletal Sciences, University of Oxford Nuffield, Oxford, UK.

Copyright

(Copyright © 2019, BMJ Publishing Group)

DOI

10.1136/bcr-2019-231804

PMID

31645382

Abstract

Firework injuries, which most commonly affect hands, are increasing in frequency and severity. We present a pictorial case of a devastating hand injury following a firework explosion in a young male patient. The blast resulted in splaying of the hand with multiple fractures, neurovascular compromise and soft tissue loss. Reconstruction involved a third-ray amputation, fracture fixation, nerve and soft tissue repair resulting in an adequate hand with near-normal appearance. Firework-related hand injuries pose a significant surgical challenge due to the combination of burn and blast forces that can compromise the function of intact vessels and nerves making salvage and reconstruction particularly difficult. Here, we propose a treatment algorithm based on current literature. Our case demonstrates, what initially appeared to be an unsalvageable injury can be reconstructed to produce a functional hand if appropriate surgical measures are taken.

© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Language: en

Keywords

orthopaedic and trauma surgery; plastic and reconstructive surgery; trauma