Profile and management of the firework-injured hand

Background: Numerous studies internationally highlight the devastating effects of firework-related injuries and the costs involved in treating these injuries, in addition to the calls to alter legislation to prevent these injuries from occurring. There has, however, been a paucity of research studie...

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Main Authors: T. Pilling, P. Govender
Format: Article
Language:English
Published: AOSIS 2016-03-01
Series:South African Family Practice
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Online Access:https://safpj.co.za/index.php/safpj/article/view/5674
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author T. Pilling
P. Govender
author_facet T. Pilling
P. Govender
author_sort T. Pilling
collection DOAJ
description Background: Numerous studies internationally highlight the devastating effects of firework-related injuries and the costs involved in treating these injuries, in addition to the calls to alter legislation to prevent these injuries from occurring. There has, however, been a paucity of research studies in the South African context that describes the complexity of the injuries sustained. The aim of this study was thus to profile the firework-injured hand and to review the management from a surgical and rehabilitation perspective. Methods: A retrospective file audit was conducted on patients who had sustained firework injuries between 2009 and 2014 (n = 65) in two hospitals in KwaZulu-Natal (KZN), South Africa. Results: The firework-injured hand has a varied profile, which appears to be dependent on the blast capacity. The thumb, index and middle fingers were predominantly affected at the level of the distal phalanges and distal interphalangeal joints resulting in amputation due to severe soft tissue injury and resultant fractures. Hand Injury Severity Scores indicated a large percentage of cases within the severe category. Medical and surgical interventions occurred within the first three to six hours post-injury and involved washout, cleaning, debridement and suturing. Formalisation of amputation was the predominant course of action. Rehabilitation was focused on assessment and hand therapy to ensure functional outcomes. Conclusions: From this study, the authors conclude that the firework-injured hand should be managed according to the resultant diagnosis, be it an amputation, fracture, or soft tissue injury, whilst managing the symptoms of oedema, pain and stiffness, which will all impact on hand function outcomes.
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spelling doaj-art-0f32bc42bf22437a9c3a46c4aec112f12025-08-20T03:47:08ZengAOSISSouth African Family Practice2078-61902078-62042016-03-0158210.4102/safp.v58i2.56744284Profile and management of the firework-injured handT. Pilling0P. Govender1Department of Occupational Therapy, Edendale Hospital, Pietermaritzburg, KwaZulu-NatalDiscipline of Occupational Therapy, School of Health Sciences, University of KwaZulu-Natal, Durban, KwaZulu-NatalBackground: Numerous studies internationally highlight the devastating effects of firework-related injuries and the costs involved in treating these injuries, in addition to the calls to alter legislation to prevent these injuries from occurring. There has, however, been a paucity of research studies in the South African context that describes the complexity of the injuries sustained. The aim of this study was thus to profile the firework-injured hand and to review the management from a surgical and rehabilitation perspective. Methods: A retrospective file audit was conducted on patients who had sustained firework injuries between 2009 and 2014 (n = 65) in two hospitals in KwaZulu-Natal (KZN), South Africa. Results: The firework-injured hand has a varied profile, which appears to be dependent on the blast capacity. The thumb, index and middle fingers were predominantly affected at the level of the distal phalanges and distal interphalangeal joints resulting in amputation due to severe soft tissue injury and resultant fractures. Hand Injury Severity Scores indicated a large percentage of cases within the severe category. Medical and surgical interventions occurred within the first three to six hours post-injury and involved washout, cleaning, debridement and suturing. Formalisation of amputation was the predominant course of action. Rehabilitation was focused on assessment and hand therapy to ensure functional outcomes. Conclusions: From this study, the authors conclude that the firework-injured hand should be managed according to the resultant diagnosis, be it an amputation, fracture, or soft tissue injury, whilst managing the symptoms of oedema, pain and stiffness, which will all impact on hand function outcomes.https://safpj.co.za/index.php/safpj/article/view/5674hand functionhand rehabilitationhand therapysoft tissue injuriestraumatic amputation
spellingShingle T. Pilling
P. Govender
Profile and management of the firework-injured hand
South African Family Practice
hand function
hand rehabilitation
hand therapy
soft tissue injuries
traumatic amputation
title Profile and management of the firework-injured hand
title_full Profile and management of the firework-injured hand
title_fullStr Profile and management of the firework-injured hand
title_full_unstemmed Profile and management of the firework-injured hand
title_short Profile and management of the firework-injured hand
title_sort profile and management of the firework injured hand
topic hand function
hand rehabilitation
hand therapy
soft tissue injuries
traumatic amputation
url https://safpj.co.za/index.php/safpj/article/view/5674
work_keys_str_mv AT tpilling profileandmanagementofthefireworkinjuredhand
AT pgovender profileandmanagementofthefireworkinjuredhand