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General Orthopaedics

Fire Cracker Injuries to the Hand during the Christmas Festive Season

The South African Orthopaedic Association (SAOA) 57th Annual Congress



Abstract

Introduction:

During the Christmas period a number of patients are admitted to the Chris Hani Baragwanath Academic Hospital (CHBAH) Hand Unit with explosive injuries to their hands caused by firecrackers. South African legislation restricts the sale and use of fireworks to adults, with a limitation being placed on the size of explosive and type of commercial outlet. Despite this an inordinate amount of explosive hand injuries are admitted over the festive season.

Aim:

To evaluate the epidemiological pattern of firecracker injuries to the hand during the Christmas festive period and assess contributing factors. Comparison to a previous study in 2008 will also be evaluated.

Method:

Patients with firecracker injuries to the hand were interviewed. Demographic information, events surrounding the incident including alcohol use, and origin of the explosive were recorded. Injuries were classified into minor, moderate and severe based on the amount of soft tissue and bony damage. Treatment and complications was recorded. The data is also compared to previous data obtained in 2008.

Results:

26 patients were admitted. 2 patients were injured with explosives from a legal source. Alcohol use was implicated in 10 of the injuries. 17 amputations were performed at various levels, 9 fractures and 2 dislocations were stabilised with K-wires. Sepsis was more common in severe injuries. The majority of patients were injured from mis-use with several patients suffering injuries following removal of explosives from children or from other people throwing explosives at them or their family. These results are similar to those obtained in 2008.

Conclusion:

A large number of patients are injured by firecrackers during the festive period. Injuries are severe. Lack of law enforcement, alcohol and misuse are contributing factors in these injuries. No significant change has occurred in the pattern of injury between 2008 and 2011.