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Case reports of pediatric electrical finger burn injuries' management and late- onset complications
Aba Lőrincz1, Zsófia Csákvári2, Tibor Máthé3
11 Pécsi Tudományegyetem, Általános Orvostudományi Kar, Transzlációs Medicina Intézet, Termofiziológia Tanszék Pécs Magyarország.
Insights
Pediatric electrical finger injuries, though rare, can cause deep tissue damage and growth plate issues. Long-term monitoring is crucial for managing potential deformities and complications in children.
Area of Science:
- Pediatric surgery
- Traumatology
- Burn management
Background:
- Pediatric electrical injuries are uncommon, accounting for 2-10% of all burn causes.
- Assessing the severity of electrical burns in children is difficult due to small entry/exit wounds.
- These injuries can lead to deep necrosis, affecting skin, soft tissue, bone, and growth plates, potentially causing secondary deformities.
Observation:
- Case 1: A 15-year-old boy sustained a third-degree burn on his right index finger from an electrical wire.
- Surgical management included necrectomy and a cross-finger flap, with observed ulnar deviation and distal phalanx bone atrophy post-operatively.
- Case 2: A 2-year-old girl suffered third-degree burns to her thumb and hypothenar region from a power outlet injury.
Findings:
- The boy's electrical finger injury required necrectomy and flap reconstruction, revealing late-onset ulnar deviation and bone atrophy.
- The girl's thumb injury underwent necrectomy and flap reconstruction with skin grafting; her follow-up is ongoing.
- Both cases highlight the potential for significant tissue damage and the need for vigilant long-term follow-up.
Implications:
- Effective management of pediatric electrical finger injuries requires addressing both immediate tissue loss and potential long-term functional and aesthetic consequences.
- Late-onset complications, such as deformities and bone atrophy, underscore the necessity of prolonged patient monitoring.
- Further research and case studies are needed to refine treatment protocols and improve outcomes for these challenging injuries.
Abstract:
Pediatric electrical injuries are rare; they only constitute 2-10% of all burn causes. Determination of their actual severity may be challenging due to their small entry and exit wounds. Deep necrosis develops during electrical burns in most cases. These injuries can damage the skin, soft and bone tissues, and in children, the growth plate, which may cause secondary deformities. The objective of these case reports was the presentation of paediatric electrical finger injuries' management and late-onset complications. A 15-year-old boy touched an electric wire while changing a lightbulb, which caused a burn injury on his right index finger. During the physical examination, a 25 x 14 mm, third-degree burn was identified volarly, above the distal interphalangeal joint as an entry wound, and an 8 x 7 mm exit site occurred dorsally at the nailbed's lateral edge. Necrectomy and cross finger flap surgery were performed. The cross flap was separated three weeks after the primary reconstruction. Throughout the follow-up examinations, the ulnar deviation of the distal digit was observed. X-ray confirmed the bone atrophy of the distal phalanx base. A 2-year old girl inserted a nail into the power outlet, causing third-degree burns on her thumb around the interphalangeal joint and hypothenar region. After necrectomy, the thumb's skin defect was reconstructed with a rotated flap, while the donor site received full-thickness skin graft transplantation. The follow-up of the child is still ongoing. Long term follow-up of these patients is necessary to identify and treat late-onset complications.
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