versão On-line ISSN 2309-8309
versão impressa ISSN 1681-150X
SA orthop. j. vol.7 no.1 Pretoria Jan./Mar. 2008
BR GelbartI; UNF UkundaI; J MullerII; W StuartII
IRegistrars, Department of Orthopaedics, University of Witwatersrand, Johannesburg
IIConsultant surgeons, Hand Unit, CH Baragwanath Hospital, Soweto
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.
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1. Smith GA, Knapp JF, Barnett TM, Shields BJ. The rockets' red glare, the bombs bursting in air: fireworks-related injuries to children. Pediatrics 1996;98(1):1-9. [ Links ]
2. See LC, Lo SK. Epidemiology of fireworks injuries: the National Electronic Injury Surveillance System, 19801989. Ann Emerg Med 1994;24(1):46-50. [ Links ]
3. Jones D, Lee W, Rea S, Donnell MO, Eadie PA. Firework injuries presenting to a national burn's unit. Ir Med J 2004;97(8):244-5. [ Links ]
4. Ipsen T, Jorgsholm PB. [Fireworks-caused injuries in Denmark]. Ugeskr Laeger 1997;159(50):7492-4. [ Links ]
5. Cracknell NR, Mills DS. A double-blind placebo-controlled study into the efficacy of a homeopathic remedy for fear of firework noises in the dog (Canis familiaris). Vet J 2007. [ Links ]
6. MacKenzie DN, Green JA, Viglione W. Firecracker injuries to the hand. Med J Aust 2001;174(5):231-2. [ Links ]
7. Clarke JA, Langley JD. Firework related injury in New Zealand. NZ Med J 1994;107(988):423-5. [ Links ]
8. Moore RS, Jr., Tan V, Dormans JP, Bozentka DJ. Major pediatric hand trauma associated with fireworks. J Orthop Trauma 2000;14(6):426-8. [ Links ]
9. Witsaman RJ, Comstock RD, Smith GA. Pediatric fireworks-related injuries in the United States: 1990-2003. Pediatrics 2006;118(1):296-303. [ Links ]
10. Hahn P, Brederlau J, Krimmer H, Lanz U. Explosion injuries of the hand. Spatial relationship and injury pattern. J Hand Surg [Br] 1996;21(6):785-7.
11. Fogarty BJ, Gordon DJ. Firework related injury and legislation: the epidemiology of firework injuries and the effect of legislation in Northern Ireland. Burns 1999;25(1):53-6. [ Links ]
Dr BR Gelbart
PO Box 28985
Sandringham, Johannesburg, 2131
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.