Gold panner blast hand

• Published in: Hand surgery and rehabilitation 2020-10, Vol.39 (5), p.393-401
• Main Authors: Diallo, M., Soulama, M., Compaoré, N.A., Kaboré, D.S.R., Ouédraogo, G.A., Dakouré, P.W.H.
• Format: Article
• Language: English
• Subjects: Amputation; Artisanal gold mining; Blast hand; Burkina Faso; Dynamite; Main de blast; Orpaillage
• ISSN: 2468-1229; 2468-1210
• DOI: 10.1016/j.hansur.2020.03.001

“Blast hand” is a traumatic hand injury related to an explosion. Artisanal gold miners use dynamite to excavate gold pits; such activities expose them to blast hand injuries. This work aims to study blast injuries to gold miners’ hands. A 25-month retrospective study was performed. Data on the traumatic event, patients, and injuries were collected and analyzed. Dedicated classifications and scores were used to evaluate the injury topography, injury severity, physical dependence, and aesthetic impact. Data were analyzed statistically. Thirty patients with 46 blast hand injuries among 516 hand injuries were collected. All patients were males and full-time artisanal gold miners. They were seen in the emergency room an average of 10.2hours (1–72) after the explosion. Explosions were caused by a 500g dynamite charge in all cases. The detonation was mainly thermal (n=13), triggered by the patient himself (n=24) and inside the gold pit (n=20). Injuries were bilateral (53%) or left side predominant (59%). Complex injuries were present in 21 hands. The MHISS (Modified Hand Injury Severity Score) was severe (n=7) and major (n=32). Associated injuries were musculoskeletal (n=12), ophthalmologic (n=14) and maxillofacial (n=10). Complexes injuries were correlated to being inside the pit at the time of the explosion. Treatment was conservative more often (n=33) than amputation (n=13). The functional recovery was complete in 22 hands (10 patients). Return to work at the same level was possible for only eight hands (5 patients). The presence of local sequelae or associated injuries negatively impacted the return to work. In Burkina Faso, gold miner's blast hand injuries cause post-traumatic social and professional reintegration issues. Better regulation of artisanal gold mining and expansion of treatment modalities (microsurgery, hand rehabilitation, splinting) may improve the outcome. L’exploitation artisanale d’or ou orpaillage utilise des explosifs de type dynamite comme moyen de creusement des puits de mine d’or artisanal. Cette activité expose à des lésions de blast des mains des orpailleurs. L’objectif de ce travail est l’étude des mains de blast de l’orpailleur. Une étude rétrospective continue de 25 mois a été conduite. Les variables liées au traumatisme, au traumatisé et aux lésions ont été collectées et analysées à l'aide d'un logiciel de statistiques. Trente patients présentant 46 mains de blast de l’orpailleur ont été colligés parmi 516 traumatisés de la main.