Clinical Profile of Patients with Manus Fracture Caused by Firecracker Blast


  • Pamudji Utomo Department of Orthopaedics and Traumatology, Prof. Dr. R. Soeharso Orthopaedics Hospital/Faculty of Medicine, Universitas Sebelas Maret/Karima Utama Surgical Hospital, Surakarta
  • Totok Siswanto Department of Emergency, Karima Utama Surgical Hospital, Surakarta


Background: Fireworks are traditionally used by various cultures or groups for celebrations. Estimated 10,000 to 12,600 people are injured because of fireworks in America every year. The type of fireworks that cause the highest injury is firecrackers with the incidence rate of 30% to 67% of all cases of injury due to fireworks. Indo­nesia is a country with the largest Muslim popu­lation in the world and firecrackers are often used to welcome Ramadan and Eid al-Fitr. This study aimed to report the Clinical pro­file of patients with manus fracture caused by firecracker blast.

Case Presentation: The case study was taken from patients of Karima Utama Surgical Hos­pital, Surakarta, Indonesia, during Ramadan and Eid al-Fitr (from May 14 to June 15) 2018. A total of 36 patients were fractured due to firework explosions recorded in medical records during that period. Data such as gender, age and fracture diagnosis were collected in this study.

Results: Males have a higher prevalence of 28 (78%) than female 8 (22%), with the highest group age between 11 to 20 years with 11 cases (31%) and more than 60 years being the lowest age group with 2 (6 %) cases of a total of 36 res­pon­dents. The right hand as the dominant hand has an injury incidence rate of 31 (86%) com­pa­red to the left hand 5 (14%) and more often oc­curs single fracture 22 (61%) compared to mul­ti­ple fractures 14 (39%) including the amputated phalanx.

Conclusion: Our study showed 36 patients had fractures of the manus due to firecrackers, with the majority of male victims 28 (78%) and single manus fractures 22 (61%) with the right-hand dominance at the age between 11 to 20 years.

Keywords: manus fracture, firecracker


Pamudji Utomo. Department of Orthopedics and Traumatology Prof. Dr. R. Soeharso Orthopedics Hospital, Surakarta. Email: utomodr­@ya­hoo.­com.

Indonesian Journal of Medicine (2020), 05(01): 57-62


Adhikari S, Bandyopadhyay T, Sarkar T, Saha JK (2013). Blast injuries to the hand: Pathomechanics, patterns and treatment. J Emerg Trauma Shock. 6(1): 29-36.

Cletus O, Kennedy E, Gabriel O, Benjamin O, Christopher O, Joyce I (2016). Blast injuries to the hand from celebrations gone wrong – A series of disabling injuries from firecrackers. Int J of Forensic Med Invest. 2(1): 36-40.

Feehan LM, Sheps SB (2006). Incidence and demographics of hand fractures in British Columbia, Canada: a population based study. J Hand Surg Am. 31(7): 1068-74.

Gelbart BR, Ukunda UNF, Muller J, Stuart W (2008). An evaluation of firework injuries to the hand – New York 2007. SA Orthopaedic Journal. 16-26

Gopalakrishnan R, Shivakami T, Sugapradha GR (2016). Prevalence and pattern of cracker blast injury of the hand. Int Surgery Journal. 3(2): 831-836.

Gordon W, Kuhn K, Staeheli G, Dromsky D (2015). Challenges in definitive fracture management of blast injuries. Curr Rev Musculoskelet Med. 8: 290-297.

Hatamabadi HR, Tabatabaey A, Khoramian KM (2013). Firecracker injuries during chaharshanbeh soori festival in Iran: A Case Series Study. Arch Trauma Res. 2(1): 46-49.

Hazani R, Buntic RF, Brooks D (2009). Patterns in blast injuries to the hand. HAND (N.Y). 4(1): 44-49.

Jameel MR, Galketiya KB, Samarasinghe TM (2018). Penetrating injury to Zone II of the neck causing laryngotracheal injury following a firecracker blast: first reported case. The Sri Lanka Journal of Surgery. 36(4): 35-37.

Kettani H (2010). Muslim population in Asia: 1950 – 2020. Int J of Environ Sci Dev. 1(2): 143-153.

Lemonic DM (2011). Bombings and blast injuries: A primer for physicians. American J Clin Med. 8(3): 134-140.

Ootes D, Lambers KT, Ring DC (2017). The epidemiology of upper extremity injuries presenting to the emergency department in the United States. HAND (N.Y). 7(1):18-22. Retrieved from

Pilling T and Govander T (2016). Profile and Management of the Firework-Injured Hand. South African Family Practice. 58(2): 48-53.

Premlal AP, Mohan M, Beevi K, Komalarani T (2018). Clinical profile of firework disaster in Kerala: Lesson learnt. Int Sur J. 5(8): 2771-2776

Rajeswari B, Shankari B, Selvaraj A (2016). Epidemiology of cracker (firework) injuries in a tertiary burn care center. Int J Applied Sci. 4(1): 6-18.

Une V, Khaire BS, Melmane S (2015). A Rare Injury Associated with Firecracker. Bombay Hospital J. 57(2): 194-196. Retrieved from