Prevalence and patterns of cracker blast injuries of the hand

Abstract

Background: Firecrackers are used to celebrate Diwali, Christmas, New Year, after matches, during wedding and death processions. The purpose of this study is to review the prevalence and patterns of cracker blast injuries of the hand in the community and to outline the possible pathomechanics of these patterns of injuries. Methods: A retrospective study of patients admitted with cracker blast injuries of the hand in our department between 2012 and 2015 was made. The patients with cracker blast injuries of the hand were grouped as mild, moderate or severe with the help of X-rays, clinical photographs and operative notes. Results: 120 patients of cracker blast hand injuries were treated in the department of plastic surgery between 2012 and 2015. Most of the patients were males. The age group was 6-58 years with an average of 26 years. The commonest cause of injury was firework misuse (56%), followed by device failure (40%). Superficial burns were treated with dressings. Certain wounds needed only thorough cleansing of the wound and primary suturing. Patients with severe injuries had amputations of part or whole of the hand. Other patients were managed with tendon repair, neurovascular repair, fracture fixation, and flap cover. Conclusions: Stiffness is common after blast injuries and the functional loss is long lasting or permanent. By creating awareness regarding safety precautions, encouraging professional displays and motivating manufacturers to adhere to strict quality control the disability due to cracker blast hand injuries can be reduced.