Severe Hand Injuries Caused by a Mole Gun

Abstract

Abstract Objective: Injuries by mole guns differ from other firearm injuries primarily because they are close-range, low-energy injuries that are highly contaminated owing to contact with contaminated surfaces and the presence of numerous residual foreign bodies within the wound. The aim of this study was to share our surgical experience regarding the repair of severe hand injuries caused by mole gun. Materials and Methods: This retrospective study included 11 patients with hand injuries. Data obtained from the patients included age, gender, dominant or non-dominant hand and injuries to all vital structures, reconstructive procedures were assessed, categorized, and recorded. Results: Ten patients had defects in one or several common digital branches of the median nerve in areas ranging from the distal part of the carpal tunnel to the distal palmar crease. All patients had flexor and extensor tendon injuries in all fingers except for the first finger. Reconstruction of soft tissue and skin defects was carried out with an interpolation flap planned from the random-based subpectoral-paraumbilical region in five patients, an SCIA-based groin flap in four patients, a reverse-radial forearm flap in one patient, and an adipofascial flap planned from forearm in one patient. Conclusion: Mole gun injuries typically include all structures of hand and repair procedures involve every anatomic structure of the hand. An early and effective surgical operation followed by prolonged and effective physical therapy protocols are vital for regaining the full spectrum of hand functions. Keywords: mole gun; hand injury; flap; reconstruction; tendon; nerve