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Penetrating injury of the hand with a door handle: a case report
- Kiran Singisetti1Email author,
- Michail Kokkinakis1 and
- Nanjappa Shankar1
https://doi.org/10.1186/1752-1947-2-377
© Singisetti et al; licensee BioMed Central Ltd. 2008
Received: 27 January 2008
Accepted: 08 December 2008
Published: 08 December 2008
Abstract
Introduction
Penetrating injuries of the hand with various sharp objects have previously been reported. In this report we describe an unusual penetrating injury of the hand caused by a door handle.
Case presentation
A 32-year-old woman presented with a door handle stuck into her hand. After a preliminary assessment she was immediately taken to theatre. Broad spectrum antibiotics were administered along with tetanus toxoid. Soft tissue, including neurovascular integrity, was assessed and confirmed during the operation. She had a good functional recovery at follow-up.
Conclusion
A door handle can occasionally cause a penetrating injury of the hand which should be treated with early intervention, including a careful assessment of soft tissue and neurovascular integrity.
Keywords
Introduction
Doors and door related injuries have been reported in the literature but most often they are related to crushing of the fingers, particularly the tips. Minor injuries often involve bruising or a blackened fingernail when a hand is caught in the latch end of the door as someone carelessly closes it. Sometimes the injury is more serious such as degloving injuries or fractures [1]. Injuries related to door handles have been very infrequently reported. Pointed door handles have been reported to pose a significant risk of ocular and peri-ocular injuries among young children [2, 3]. We report an unusual injury where a door handle was found completely embedded into the hand of a woman.
Case presentation
Clinical photograph of hand.
Antero-posterior radiograph of hand.
Lateral radiograph of hand.
Discussion
Penetrating injuries of the hand are generally encountered in cases of gunshot and stab injuries. To our knowledge, a penetrating injury by a door handle has not previously been described in the literature. A debridement procedure and antibiotic cover are generally the essence of primary management. The use of broad spectrum antibiotics such as third generation cephalosporins is preferred but this may need to be modified depending on individual situations [4]. If surgical removal of a foreign body or surgical exploration of a puncture wound is decided upon, it must be performed under adequate anaesthesia and tourniquet control [5]. Attention to the integrity of the neurovascular and musculotendinous structures is important to improve the final outcome. Early mobilisation and physiotherapy helps in the return of functional activities after such injuries [6].
Conclusion
Objects such as door handles can occasionally cause penetrating injuries of the hand. Such injuries should be managed with meticulous early surgical exploration and care to check neurovascular integrity.
Consent
Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
Declarations
Authors’ Affiliations
References
- Sinha M: An unusual foreign body in the hand. J Hand Surg Eur Vol. 2007, 32 (2): 231-232. 10.1016/j.jhsb.2006.11.006.View ArticlePubMedGoogle Scholar
- Chaudhry IA, Al-Sharif AM, Shamsi FA, Elzaridi E, Al-Rashed W: Severe ocular injuries from pointed door handles. Ophthalmology. 2005, 112 (10): 1834-1837. 10.1016/j.ophtha.2005.04.028.View ArticlePubMedGoogle Scholar
- Kozielec GF, To K: Penetrating eye injury from a metal wedge. Ophthalmic Surg Lasers. 1999, 30 (1): 59-60.PubMedGoogle Scholar
- Mirzayan R, Schnall SB, Chon JH, Holtom PD, Patzakis MJ, Stevanovic MV: Culture results and amputation rates in high-pressure paint gun injuries of the hand. Orthopedics. 2001, 24 (6): 587-589.PubMedGoogle Scholar
- Stein F: Foreign body injuries of the hand. Emerg Med Clin North Am. 1985, 3 (2): 383-390.PubMedGoogle Scholar
- Lerner A, Stein H, Stolero J, Volpin G: Unusual penetrating hand injuries due to underwater fishing harpoons. Orthopedics. 2001, 24 (4): 385-387.PubMedGoogle Scholar
Copyright
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.