Grinding machine injury of the hand: a preliminary report.

Case notes of 20 patients who presented with grinding machine injury to the hand from April 1984 to March 1990 were analysed for pattern of injury, method of management and outcome of treatment. Thirteen cases were seen in the last three years of this period (the SAP era) compared to seven cases in first three years of the period (the pre-SAP era). Children from low socio-economic class were the commonest victims. The right hand was commonly involved alone. Most injuries were multiple but the skin of the dorsum of the hand and ring finger were most commonly injured. Associated fractures of the metacarpals, carpals, joint dislocations in the hand and injuries to other parts of the body were uncommon. Thorough washing of the wound with soap and water, careful, limited initial debridement, elevation of the hand, antibiotics, antitetanus prophylaxis and early intensive hand physiotherapy yielded good to excellent results in seventeen patients. Eventhough the viability of the crushed skin on the dorsum of the hand may be questionable at initial presentation most of it will 'take' and we advocate that as much of this skin as is possible should be spared.