Hand injuries due to firework devices: a series of 58 cases

Fireworks or firecrackers can cause serious accidents. They are classified from K1 to K4 according to the amount of powder they contain. In Alsace (France), a type-K1 firecracker is available on the free market and the K2 and K3 ones are prohibited. The aim of this study was to reveal the effects of measures taken in order to prevent repercussions related to hand injuries caused by fireworks. Patients who fell victim to firework incidents have been recorded since 2006, starting date of the prevention campaign. Records have been taken on the circumstances, the group of firecracker, the level of injury and the severity of the injury in four stages. Our series included 62 hands from 58 patients (average age: 25 years), including two women. Most of them sustained their injury during the night of New Year's Eve. The study dealt with 21 K1, and 35 K2 or K3. We registered 29 cases of grade I, 2 grades II, 21 grades III and 9 grades IV. One patient died. The numbers of consultations, K2/K3 injuries and number of surgeries increased from 2006 to 2012. Our results show that firework-related injuries to the hand are serious, pluridigital, multistage and/or bilateral. Prevention was ineffective but should be improved and strengthened, as a total ban on fireworks is a counterproductive measure.