Characteristics and trends of fireworks-related hand injuries and treatment at a Level I trauma center

Firework-related injuries can have devastating consequences, often resulting in permanent damage or amputation, with incidence rising in recent years. This study characterizes firework-related hand injuries treated at a Level 1 Trauma Center over a 10-year period, analyzing demographics, injury patterns, outcomes, and trends.

The medical records of patients treated at a Level I trauma center for firework-related hand injuries between January 2013 and January 2023 were retrospectively reviewed. Variables analyzed included patient demographics, injury characteristics, hospital course, treatment details, and socioeconomic factors.

The study included 33 male and 2 female patients aged 9-74 years (mean age 31 years). Injuries occurred in 88.6 % of cases due to patients holding fireworks, often in their dominant hand (42.9 %). Fractures occurred in 77.1 % of cases, traumatic amputations in 34.3 %, vascular injuries in 45.7 %, and nerve injuries in 48.6 %. Surgery was required in 82.9 % of patients, with irrigation and debridement (74.3 %) and revision amputation (60 %) being the most common procedures. The average length of hospitalization was 4.64 days, and many patients resided in lower-income areas, with 62.8 % from zip codes reporting an annual household income below $60,000.

Firework-related hand injuries impose significant physical and socioeconomic burdens, with most patients requiring surgery for fractures, suffering vascular or nerve damage, or undergoing traumatic or surgical amputation. Young adult males from lower-income, socially vulnerable areas were most affected. Future prevention efforts should focus on public health and legislative initiatives to reduce these injuries.

Prognostic IV.