Fireworks injuries of the hand commonly occur not only on July 4th but throughout the year. These injuries range from soft tissue injuries often with loss of skin and subcutaneous tissue to disruption of the flexor and extensor tendons to fractures with or without bone loss to mutilating injuries of the hand with need for possible revascularization or replantation. In the more severe cases, replantation and revascularization are not even feasible due to tremendous destruction to the soft tissues and bone with amputation being the only option.

As with other injuries, prevention is key. Safety in the use of fireworks is of the upmost importance. Even among fireworks professionals, these injuries occur.

In dealing with fireworks injuries, it is important to assess the extent of damage to the body in addition to the hand. While the hands are most frequently involved by the very nature of the injury mechanism, other parts of the body such as the face, torso and legs may be involved. Some of these injuries resemble burns and may be treated as such.

After the accident, the hand surgeon carefully evaluates the injured hand and proceeds to salvage as much viable tissue as possible. It is important to consider not only the injury but the different steps in future reconstruction and the rehabilitative process. In the more severe and extensive injuries, patients often require multiple staged procedures in hope of regaining as much useful function as possible. Often, the patient is stabilized in the Emergency Department and surgery is performed to salvage as much soft tissue and bone as possible. At this time, it is critical that the patient seek out a hand surgeon experienced in dealing with these complex injuries. Few hand surgeons have this type of experience.

An occupational therapist has several modalities to work with the patient having a painful fingertip. The hand surgeon also has various options to restore useful function to the injured finger. While seemingly minor, compared to more extensive injuries involving multiple structures, they still require appropriate care from an experienced hand surgeon.

At The Chicago Institute for Hand Surgery & Rehabilitation, Dr. Norman Weinzweig has treated hundreds of similar injuries with excellent clinical and aesthetic results, allowing patients to get back to the workplace or to their recreational activities as soon as possible.