SA Orthopaedic Journal
versión On-line ISSN 2309-8309
A growing tradition among the residents of Johannesburg, South Africa, is to light firecrackers to welcome the New Year. Despite legal limitations on the sale of these explosives, firecrackers as well as larger fireworks are freely available in stores and on the streets of Johannesburg. Over the first few weeks of January 2007, our hand unit treated 34 patients who sustained blast injuries due to firecrackers. The injuries were sustained by patients of all ages. Five children were under 8 years of age, with the peak age group being 20 to 35 years. Only 50% of the injured were employed and 18% were scholars. The majority of injuries were to the right hand, the dominant hand in most patients. Twenty-four patients injured three or more fingers with some fingers having more than one separate injury. Twenty-one patients ended up with tissue loss of one or more digits. Thirty patients were debrided and/or repaired within five days of the injury. Three patients did not return for follow-up, two developed localised wound sepsis and required re-debridement, and a further three patients required extended follow-up for dressings. The remainder of the wounds healed uneventfully. Despite adequate wound healing, the functional loss and side-effects of these injuries are long-lasting or permanent. Social, legal and enforcement solutions are essential for the adequate resolution of this problem.