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Arie Nugroho, Arie
Jurusan Gizi Poltekkes Kemenkes Tanjungkarang
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Blast injury of the hand in a pediatric patient with open fracture: A case report Nugroho, Arie; Zahra, Afifah Az; Yahya, Taufik Nur
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 17, No 1, (2026)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol17.Iss1.art15

Abstract

Blast injuries can cause severe, multi-tissue damage, including open fractures and extensive lacerations. Management of pediatric hand blast injuries is particularly challenging due to a high risk of contamination and infection. We report the case of a 10-year-old boy who sustained a left-hand blast injury caused by a firecracker. The patient presented with a contaminated lacerated wound, active bleeding, tissue avulsion, and retained foreign bodies, accompanied by crepitus and cyanosis of the index finger. Initial management included debridement and irrigation. Surgical intervention consisted thorough debridement, exploration of tendon and neurovascular structure, and K-wires fixation of the index finger. Despite appropriate initial management, the patient developed chronic necrotic tissue infection, necessitating ray amputation of the index finger to control the infection. Further evaluation suggested that primary vascular disruption, exacerbated by contamination and infection, contributed to progressive necrosis, particularly at the metacarpophalangeal level. To prevent further infection spread and salvage overall hand function, repeated debridement followed by amputation at the metacarpophalangeal joint and removal of fixation wires was performed. Structured rehabilitation was subsequently initiated. Pediatric hand blast injuries represent complex traumatic conditions with a high risk of tissue necrosis. Early diagnosis and aggressive surgical management are essential; however, compromised tissue viability and severe infections may necessitate amputation as a limb-salvage strategy. This case underscores the importance of comprehensive management and highlights the need for improved community-based prevention efforts.
Co-Authors Abdullah Abdullah Abunizar, Lutfi Adam, Rizal Syihab Saputra Adinda Juwita Sari Affandy Affandy Agung Pramono, Agung Aidina Ristyawan Aidina Ristyawan, Aidina Amarya, Theo Krisna Ameliya, Putri Anggreini, Emi Annisa, Viviane Antun Rahmadi Ardio, Gletser Yustitito Ariansyah, Damas Baik Arie, Theo Yan ARMYANTO, JODI Aswita Amir Bella Novita Muktiari Bertalina Bertalina Bertalina Ny Dwi Fajarsari, Gesti Dwi Harini DWI HARINI Endang Sri Wahyuni Erna Daniati Farhan Gagat Retnanto Febrina, Binta Setya Ferdian Ahmat Felmidi Ferianto, Risky Hardhono Susanto Henityastama, Milinian Tree Multi Hermawan Nur Wahiid Hery Widijanto Indriyani, Reni Irawati, Elsa Kusdalinah Kusdalinah Lestari, Afifah Kurnia Martha Irene Kartasurya Maulana, Wildan Arya Merita Putri Mufattan, Ahmad Mugiati Mugiati Muhammad Fikri Pratama Muhammad Najibulloh Muzaki Muhammad, Hasman Zhafiri Mulyani, Roza Ningrum, Dea Yuliana Ayu Ningrum, Dila Ayu Tri Suhesti Novika , Yulia Nurhapy, Dwiki Nurhindarto, Aris Nuri Aslami Ny, Bertalina P, Anggi Yuniar Pradhana, Akmal Hisyam Pramadya, Reza Candra Pranata, Dava Adistyan Pratama, Aldi Pratiwi, Amali Rica Qibtiyah, Siti Mariyatul Rahmadi, Antun Ratih Kumalasari Niswatin Rauf Tamim Rebia, Rina Afiani Reka Ainul Khasanah Retno Mayangsari, Dwi Ricardus Anggi Pramunendar Rina Firliana Rini Indriati Rino Adi Kurniawan Roza Mulyani Sakin, Kharisma Sari, Vivi Anggun Permata Sejati, Nawasari Indah Putri Siswahyudianto Soeleman, M. Arief Sucipto Sucipto Sucipto Sudarmi Sudarmi Sunarto Sunarto Sutrio Sutrio Sutrio Teguh Andriyanto Teguh Andriyanto, Teguh Tuti Hidayah Usdeka Muliani Utama, Hastari Vresti Rahma Dewi Wardani, Anita Sari Wibowo, Rizky Wiranata, Hadi Yahya, Taufik Nur Yunianto, Andi Eka Zahra, Afifah Az Zalfa, Darina