Electrical injury of wrist: classification and treatment--clinical analysis of 90 cases

Between January 1980 and December 1989, a prospective study was carried out on 114 upper limbs in 90 patients, which were electrically burned with the wrist as the current entrance site. Based upon extensive clinical investigations of arterial injury and its adverse effect on hand circulation, a grading system is suggested for electrically injured wrists based on the severity of injury. The total amputation rate was 39.4 per cent in this group, which was composed of miscellaneous cases with various injuries. However, in subgroups of Type I to Type IV, the amputation rates were 0, 0, 80 and 100 per cent, respectively. A new method to repair the circumferential wound of an electrically burned wrist as well as to bypass the blood flow to the obstructed hand, using a pedicled greater omentum transfer and vascular anastomosis between gastroepiploic artery and the palmar artery, was successfully used in a Type III case.