Being a hand Surgeon I
have come across many finger tip or finger pulp or nail injuries, resulting due
to entrapment of fingers in the door while closing it. In one case the child
himself closed the door, while majority of the times its one child closing the
door and others hand gets entrapped.
The severity of injury
depends on the fact of amount of pressure from the door, and the volume of
finger entrapped. It can range from total amputation to just pulp
avulsion.
The first and foremost
thing for us to know is that, these are common preventable injuries if door
latches are kept locked, moreover vigilance of the child that he or she does
not play close to the door or with the door. But beyond all if this occurs what
to do?
We must be aware of the
fact that despite these looking minor injuries the consequences of ill
treatment age quite grave, in my opinion if any such injury occurs to the
child, it’s important to consult and Hand Surgeon, as he is the right person trained
to manage such injuries.
To exemplify my point I
would show you a recent case that came to me, His thumb got entrapped, and
became necrotic, and thus looking like it will need amputation.
We
derided the necrotic part, and found that partial nail bed was intact, although
the nail got avulsed, all the viable elements of the pulp skin were preserved,
and reconstruction of the nail bed and the pulp of the thumb were done.
Finally the nail was re posited after
cleaning, this reposition, and gives way to the new nail, which will come
naturally over time.
The end result was that the length
and the cosmesis of the thumb in this one and half year old were preserved.
Message- Watch for door latches, and
your child playing with doors
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