Firecracker injuries to the hands can cause permanent functional loss and disfigurement. We assessed the injuries and treatment of 16 men, three women, five boys and two girls injured around New Year’s Eve between 1999 and 2004.

In 16 of the adult patients, who included a typist and a teacher, it was necessary to amputate one or more digits. Four patients lost both the thumb and the index finger, four lost the thumb and the rest lost other digits. Only soft tissue injuries were sustained by 10 of the 26 patients. Twenty patients (77%) benefited from initial debridement and primary closure alone, but the other six needed more than one procedure, and half of this group developed sepsis. The psychological impact was important in adults. Associated injuries included the loss of an eye in one patient, facial lacerations in 10 and a perforated eardrum. The mean hospital stay was 5 days.

Public education and legislative reform may help prevent these unnecessary injuries.