title: Blast injuries to the hand: Pathomechanics, patterns and treatment.
abstract: OBJECTIVE
  To characterize the common patterns of injury in detail in cases of blast injuries to the hand and to outline the possible pathomechanics of these patterns of injury while describing the treatment modalities for the same as practiced in our center.
  
  
  METHODS
  A review of admitted patients in our department from september 2009 through december 2010 of blast injuries to the hand was made. Each patient had a careful characterization of their injuries as mild, moderate or severe with the help of X-rays, clinical photographs and operative notes. The treatment of these patients during hospital stay was also documented.
  
  
  RESULTS
  Of the 55 patients studied, 5 patients suffered mild injuries with no bony injuries or dislocations, 26 patients had moderate injuries characterized by fractures and dislocations in addition to soft tissue injuries and 24 patients had severe injuries characterized by variable degrees of amputations. The most common injury type was to the radial aspect of the hand characterized by a first web split and a dislocation of the CMC joint of the thumb associated with fracture of the central metacarpals and amputations of the index and long fingers in some cases. Injury to the ulnar aspect was rare. Injuries were treated by repair as well as replacement done mostly in a serial fashion.
  
  
  CONCLUSIONS
  Depending on the mode of injury, blast injuries to the hand can have varying patterns of injury, which can have important implications in the treatment and rehabilitation of a patient.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, India.
authors.forename: Souvik
authors.initials: S
authors.lastname: Adhikari
authors.forename: Tibar
authors.initials: T
authors.lastname: Bandyopadhyay
authors.forename: Tapan
authors.initials: T
authors.lastname: Sarkar
authors.forename: Jayanta Kumar
authors.initials: JK
authors.lastname: Saha
keywords: Blast; hand; injury; pathomechanics; pattern