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Punching Glass: A 10-Year Consecutive Series.

Schaefer N, Cappello J, O'Donohue P, Phillips A, Elliott D, Daniele L - Plast Reconstr Surg Glob Open (2015)

Bottom Line: Ninety-one patients had superficial skin lacerations only and did not require operative intervention.Thorough physical examination, appropriate imaging and operative repair can improve outcomes.Preventative measures such as stricter legislation and safety glass will reduce the burden of these injures on the individual and healthcare system in Australia.

View Article: PubMed Central - PubMed

Affiliation: Cairns Hospital, Orthopaedics Department, Cairns North, QLD, Australia; and Gold Coast University Hospital, Orthopaedics Department, Southport, QLD, Australia.

ABSTRACT

Introduction: Punching glass can cause severe and debilitating injuries. The literature is scant in regards to the injury patterns, optimal management, and preventative strategies. We have reviewed our experience of these injuries at a regional Australian hospital.

Methods: A retrospective chart review of all patients who had punched glass and presented to Cairns Base Hospital between January 2003 and December 2012. Data collected included age, gender, marital status, employment status, alcohol consumption, side of injury, intent, time of presentation, damaged structures, treatment required, operative time, total hospital stay, and required follow-up.

Results: 137 eligible patients were identified during the 10-year study period. Mean age was 26.3 years. Most were men (n = 113), single (n = 122), unemployed (n = 95), and intoxicated (n = 91). Most of these injuries presented outside of normal working hours (P < 0.001). Ninety-one patients had superficial skin lacerations only and did not require operative intervention. The remaining 46 patients had a total of 46 tendon, 18 muscle, 12 nerve, 8 vessel and 5 bone injuries, and all required operative intervention. Tendon, nerve and vessel injuries were strongly associated with each other (P < 0.05).

Conclusions: This represents the largest case series of glass punching injuries in the English literature. Punching glass can cause significant morbidity in a young age group and is therefore a major public health concern. Thorough physical examination, appropriate imaging and operative repair can improve outcomes. Preventative measures such as stricter legislation and safety glass will reduce the burden of these injures on the individual and healthcare system in Australia.

No MeSH data available.


Related in: MedlinePlus

A patient who presented during the study period with a complete transection of the extensor digitorum communis tendon to the ring finger of the right hand.
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Figure 3: A patient who presented during the study period with a complete transection of the extensor digitorum communis tendon to the ring finger of the right hand.

Mentions: The superficial location of the tendons, nerves, and vessels in the forearm renders them particularly vulnerable to any penetrating trauma (Fig. 3).7,8 Tendons were the most commonly injured structure followed by muscles, nerves, vessels, and bones in descending order, which is a similar injury frequency to other studies.9,10 Zone V injuries, which are defined as those occurring between the proximal border of the transverse carpal ligament and the flexor musculotendinous junctions, have been referred to as “spaghetti wrist,” “suicide wrist,” and “full house syndrome” in the literature.11,12 These injuries can be devastating in nature, involving as many as 16 different structures, including 12 tendons, 2 arteries, and 2 nerves.12 The term spaghetti wrist was first defined as 3 completely transected structures (tendon, nerve, or vessel) resulting from a volar wrist laceration.8 Fifteen patients in our case series had spaghetti wrist injuries, the worst case involving 8 completely transected structures (6 tendons, 1 artery, and 1 nerve). Not surprisingly, tendon, nerve, and vessel damage were strongly associated with each other in our study population.2


Punching Glass: A 10-Year Consecutive Series.

Schaefer N, Cappello J, O'Donohue P, Phillips A, Elliott D, Daniele L - Plast Reconstr Surg Glob Open (2015)

A patient who presented during the study period with a complete transection of the extensor digitorum communis tendon to the ring finger of the right hand.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4494506&req=5

Figure 3: A patient who presented during the study period with a complete transection of the extensor digitorum communis tendon to the ring finger of the right hand.
Mentions: The superficial location of the tendons, nerves, and vessels in the forearm renders them particularly vulnerable to any penetrating trauma (Fig. 3).7,8 Tendons were the most commonly injured structure followed by muscles, nerves, vessels, and bones in descending order, which is a similar injury frequency to other studies.9,10 Zone V injuries, which are defined as those occurring between the proximal border of the transverse carpal ligament and the flexor musculotendinous junctions, have been referred to as “spaghetti wrist,” “suicide wrist,” and “full house syndrome” in the literature.11,12 These injuries can be devastating in nature, involving as many as 16 different structures, including 12 tendons, 2 arteries, and 2 nerves.12 The term spaghetti wrist was first defined as 3 completely transected structures (tendon, nerve, or vessel) resulting from a volar wrist laceration.8 Fifteen patients in our case series had spaghetti wrist injuries, the worst case involving 8 completely transected structures (6 tendons, 1 artery, and 1 nerve). Not surprisingly, tendon, nerve, and vessel damage were strongly associated with each other in our study population.2

Bottom Line: Ninety-one patients had superficial skin lacerations only and did not require operative intervention.Thorough physical examination, appropriate imaging and operative repair can improve outcomes.Preventative measures such as stricter legislation and safety glass will reduce the burden of these injures on the individual and healthcare system in Australia.

View Article: PubMed Central - PubMed

Affiliation: Cairns Hospital, Orthopaedics Department, Cairns North, QLD, Australia; and Gold Coast University Hospital, Orthopaedics Department, Southport, QLD, Australia.

ABSTRACT

Introduction: Punching glass can cause severe and debilitating injuries. The literature is scant in regards to the injury patterns, optimal management, and preventative strategies. We have reviewed our experience of these injuries at a regional Australian hospital.

Methods: A retrospective chart review of all patients who had punched glass and presented to Cairns Base Hospital between January 2003 and December 2012. Data collected included age, gender, marital status, employment status, alcohol consumption, side of injury, intent, time of presentation, damaged structures, treatment required, operative time, total hospital stay, and required follow-up.

Results: 137 eligible patients were identified during the 10-year study period. Mean age was 26.3 years. Most were men (n = 113), single (n = 122), unemployed (n = 95), and intoxicated (n = 91). Most of these injuries presented outside of normal working hours (P < 0.001). Ninety-one patients had superficial skin lacerations only and did not require operative intervention. The remaining 46 patients had a total of 46 tendon, 18 muscle, 12 nerve, 8 vessel and 5 bone injuries, and all required operative intervention. Tendon, nerve and vessel injuries were strongly associated with each other (P < 0.05).

Conclusions: This represents the largest case series of glass punching injuries in the English literature. Punching glass can cause significant morbidity in a young age group and is therefore a major public health concern. Thorough physical examination, appropriate imaging and operative repair can improve outcomes. Preventative measures such as stricter legislation and safety glass will reduce the burden of these injures on the individual and healthcare system in Australia.

No MeSH data available.


Related in: MedlinePlus