• Matthias Frank, Uli Schmucker, Matthias Napp, Dirk Stengel, Peter Hinz, Axel Ekkernkamp, and Gerrit Matthes.
• Department of Trauma and Orthopedic Surgery, Ernst-Moritz-Arndt-University of Greifswald, Greifswald, Germany. matthias.frank@uni-greifswald.de
• J Trauma. 2009 Sep 1; 67 (3): 617-23.

BackgroundHigh-pressure blast injuries to the hand due to vole captive bolt devices are serious injuries that are to a great extent unknown to emergency care operators and trauma surgeons. There is no study on the functional outcome of these patients.MethodsWe assessed the functional outcome of patients with injuries inflicted by vole captive bolt devices. Therefore, a protocol consisting of a physical examination and an assessment of static muscle power (grip and pinch strength) was performed. To capture the subjective experience of patients regarding their injury related disability and impairment, the DASH follow-up questionnaire was used. Based on clinical/radiologic findings and outcome, a classification of this unique subgroup of blast injuries was developed.ResultsThe functional outcome of 34 patients suffering hand injuries due to captive bolt devices between 2004 and 2007 was assessed. A significant reduction of static muscle testing parameters compared with the uninjured hand was revealed. Fourteen patients lost a digit. Average time lost from work was 5.4 weeks.ConclusionVole captive bolt device-related hand injuries are followed by deterioration of hand function. The present observations alarmed national authorities. The manufacturers were required to take engineering and teaching measures to rule out handling errors that were identified as leading cause of injury.

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