Wringer arm injuries.

During a 20-yr period, 483 children 16 yr of age or under were hospitalized for management of a wringer arm injury. Although the majority were indigent, black males, such trauma was frequently sustained by all classes and races as well as by both sexes. Principles of treatment consisted of cleansing the abrasion wound, application of a pressure dressing from axilla to finger tips, elevation, and close observation. With the exception of a destroyed brachial vein in one patien, significant vascular injuries did not occur despite a "medical fixation" on evidences of impaired circulation. Likewise, no fractures were noted even though all patients had x-rays of the full extremity. However, there were six metacarpophalangeal dislocations, five instances of neuropathy, and one traumatic amputation. Major skin sloughs occurred in 18 children, yet only 11 of them required a skin graft.