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Washing Machine Injury of Middle Finger: A Case Report and Review of the Literature

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... They presented a case of serious upper extremity injury that required extensive reconstructive procedures to save a limb with minimum loss of function effectively. They concluded the need for an expert microvascular reconstructive team to get good outcomes for severe hand injuries [12]. ...
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Washing machines are common in most households and crucial for laundry management. However, they are associated with risks, especially in children. In this report, we present three cases of severe hand injuries in pediatric patients that resulted from attempts to unload laundry while the washing machine was still spinning. Fortunately, in all three cases, the injured hands were successfully treated with revascularization of the affected parts. Compared to revision amputation or other reconstructive techniques, finger replantation and revascularization offer the most favorable outcomes. Several preventive strategies, such as more parental supervision and thorough appliance safety training, can reduce the likelihood of such injuries. Increasing awareness and promoting safe practices can drastically reduce the frequency of potentially fatal accidents.
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Washing machines are part of every household and there are various reports of upper extremity injuries due to inadequate safety precautions while operating the machine. Most of the injuries occur when an attempt is made to remove the clothes from the machine and the hand gets caught in the spinning machine. The presentation can vary from minor soft tissue injuries to a mangled upper extremity. The chance of neurovascular damage resulting in compartment syndrome is very high. The author reports three cases of washing machine injuries to draw attention to this not so uncommon injury. The relevant literature is also considered.
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To describe washing machine related injuries in children in the United States. Injury data for 496 washing machine related injuries documented by the Consumer Product Safety Commission's National Electronic Injury Surveillance System and death certificate data files were analyzed. Gender, age, diagnosis, body part injured, disposition, location and mechanism of injury were considered in the analysis of data. The upper extremities were most frequently injured in washing machine related injuries, especially with wringer machines. Fewer than 10% of patients required admission, but automatic washers accounted for most of these and for both of the deaths. Automatic washer injuries involved a wider range of injury mechanism, including 23 children who fell from the machines while in baby seats. Though most injuries associated with washing machines are minor, some are severe and devastating. Many of the injuries could be avoided with improvements in machine design while others suggest a need for increased education of potential dangers and better supervision of children if they are allowed access to areas where washing machines are operating. Furthermore, washing machines should only be used for their intended purpose. Given the limitations of educational efforts to prevent injuries, health professionals should have a major role in public education regarding these seemingly benign household appliances.
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Microsurgical replantation has been attempted in the distal phalanx of the finger regardless of whether zones I and II were involved. There were 70 patients with 87 amputated fingers. The patients' ages ranged from 14 months to 71 years. Fifty-one fingers were completely amputated. Five of the 87 replants failed. Seven fingers showed partial necrosis, but all others had no necrosis. Of the 74 fingers that had partial or no necrosis more than 6 months after surgery, 60 fingers (81.1%) are in excellent condition and have good daily use, and 14.8% have at least partial use. The patients were satisfied with the cosmetic appearance in all of the replanted fingers that survived.