An unusual form of ′finger stuck in a hole′ injury in a child

Abstract

A 3-year-old child was referred with a history of the index finger being stuck in a plate hole. 'Idli' or simply steamed rice cake, made by steaming a batter consisting of fermented black lentils (de-husked) and rice is a south Indian delicacy that is prepared in moulds where the batter is put in and steamed. The steam enters through small holes in the mould and cooks the batter. With the advent of pressure cookers, the ubiquitous idli can be prepared in steel moulds that are placed inside a pressure cooker. Our toddler had managed to ingeniously slide his finger into the central hole in the steel mould while playing with it and turning it round and round over her finger [Figure 1]a. Eventually the distal finger became edematous and it was then that the parents realized that the idly mould had become a inseparable part of their toddler's finger. All attempts at home to pull out the 'stuck finger' failed and the child was taken to a local hospital where the standard modes of removal were attempted. The child was then brought to our center. The unusual shape of the mould made us realise that cutting the plate away was the only way to remove the finger. The child was fairly co-operative and hence it was decided to try removing the 'stuck finger' under local anesthesia. Additional analgesic support and sedation was given in the form of oral syrup paracetamol and syrup triclofos. One percent solution of Lidocaine was injected as a ring block to anesthetize the index finger. An attempt was made to cut the plate with a regular wire cutter which failed. A heavy duty steel plate cutter was then procured and the steel mould was then cut into two parts across the circumference and the finger removed [Figure 1]b. Besides a small laceration on the finger that was left for secondary healing, no other injuries were noted. Language: en