ABSTRACT
Purpose: The purpose of this study was to evaluate circumstances surrounding power saw injuries. We hypothesized that power saw injuries are caused by either inexperienced or inappropriate usage of saws. Methods: A retrospective review of patients at our level 1 trauma center from January 2011 to April 2022 was conducted. Patients were screened using surgical billing records based on Current Procedural Terminology codes. Codes associated with revascularization; amputation of digits; and repair of tendon, nerve, and open metacarpal and phalanx fractures were queried. Patients who sustained power saw injuries were identified. They were then contacted by phone, and a standardized questionnaire was administered. Verbal consent was included in the standardized script, which was approved by the institutional review board. Results: One hundred eleven patients were identified who underwent surgical treatment for power saw injuries of the hands. Of them, we were able to contact 44 patients, who consented to and completed the questionnaire. Of all of the contacted patients, 40 (91%) were men, with an average age of 55 years (range, 27-80 years). No patients were intoxicated when the injury occurred. Thirty-two (73%) patients had used the same saw for more than 25 times. Sixteen (36%) patients had not received formal training regarding safe use of their saw, and 7 (16%) had removed a safety mechanism prior to the injury. Thirteen (30%) patients had used the saw on an unstable surface, and 17 (39%) reported not having changed the saw blade regularly. Conclusions: Power saw injuries occur for a multitude of reasons. Contrary to our hypothesis, more experience with the use of saws does not necessarily protect one from saw injuries. These findings highlight the need for formal training among new saw users and continuing education for the more experienced to help reduce the incidence of saw injuries that require surgical intervention. Type of study/level of evidence: Prognostic IV.
ABSTRACT
CASE: We describe a 23-year-old man who had multiple recurrences of a giant cell tumor (GCT) of the third metacarpal. Initial treatments consisted of curettage without the use of an adjuvant and bone-grafting. At the time of the latest recurrence, the lesion had extended into the capitate and the trapezoid. Treatment included third-ray resection and limited midcarpal fusion. No local recurrence was identified at more than 1 year after surgery. CONCLUSION: GCTs of the hand should be aggressively treated, but care should be taken to preserve function whenever possible.
