Firecracker blast injury to the hand in children: Classification of the thumb injury and the functional outcome assessment

Abstract

The study aimed to analyze the firecracker blast injury to the hand in children and assess the functional outcome. In addition, the article classified the firecracker blast injury pattern to the thumb in children. A retrospective cohort study was conducted between 2012 and 2020, analyzing 31 children sustaining firecracker blast injuries. The functional outcome was assessed. The author also proposed a classification based on the injury involving the webspace, flexor pollicis longus, thenar, adductor, and flexor muscles, neurovascular injury, and fractures/dislocations. There were 30 males and one female with a mean age of 6 years (range 2–13 years). The mean follow-up was 25 months (Range, 12–36 months). The author classified the injury into grades 1 (n = 9 children), 2 (n = 12), 3A (n = 8) and 3B (n = 2) based on the involved structures. All children had better functional outcomes following the reconstructive procedures based on the classification. The grades of injury did not significantly impact the functional outcome (p = 0.96). Despite the complexity and multitude of firecracker blast injuries, children performed better. The classification based on firecracker blast injury involving vital structures is simple, straightforward, and meaningful. It is helpful for decision-making at the first surgery and subsequent secondary reconstructive procedures. IV. • Firecracker blast injuries to the hand in children are complex and multitude in nature. • The vital structures are badly injured. • A new classification based on firecracker blast injury in children is vital. • It is helpful for decision-making at the first surgery and subsequent reconstructive procedures. • The functional outcomes are better in children's injuries.