Hand injuries from inflation of an air bag security system

HAND

INJURIES

FROM INFLATION SECURITY SYSTEM

OF AN AIR BAG

T. ROTH and P. MEREDITH From the Surgical Service, Merges Hospital, Switzerland

Hand injuries have occurred due to inflation of an air bag during a high velocity car accident. Journal of Hand Surgery (British and European Volume, 1993) 18B: 520-522 CASE REPORTS

joint) and a mallet finger of the left fifth digit (Fig 1). No other injuries were observed. The driver was treated conservatively and healed without sequelae. The passenger had K-wire fixation after fracture repositioning, under local anaesthesia (Fig 2). Physiotherapy was started early. K-wires were removed at 3 weeks and active therapy continued. 6 months later there was stiffness of the PIP joint and a 20” flexion deformity. The driver continued his professional activity during

A driver and a passenger retained by three-point lapshoulder belts crashed on the central railing of a motorway when their’vehicle lost control due to aquaplaning. The air bags inflated during the collision. The driver presented a superficial second degree burn with a 12 cm long blister on the radial side of the right hand and distal forearm. The passenger suffered an intraarticular palmar avulsion fracture of the middle phalanx (PIP

Fig 1

X-ray

showing

a proximal

intraarticular

fracture

of the second

phalanx 520

of the left little finger.

AIR-BAG

Fig 2

INJURIES

X-rays

after repositioning

and K-wire

fixation

THE JOURNAL

the period of the treatment, but the passenger could only resume her partially manual work 6 weeks later. DISCUSSION These injuries were caused by inflation of the air bag security system. The driver sustained an abrasion and the passenger was probably injured by direct impact on the dorsum of the little finger followed by compression of the ulnar side. Surgical treatment was needed and working days were lost due to these lesions. The air bag system was initially developed for security in aeroplanes and the technology was then applied to the automobile. Since 1981 it has been standard in some high-quality vehicles. The driver’s air bag is folded in the steering wheel and has a capacity of 70 1. The passenger’s air bag is stored in the dashboard and has a capacity of 150 1. Inflation is triggered by head-on collisions of more than 30 k.p.h., when nitrogen is released electronically from a bottle. This takes place in 25 to 30 thousandths of a second and is followed by

OF HAND

SURGERY

VOL. 18B No. 4 AUGUST

1993

immediate deflation. Its use should prevent direct craniocerebral trauma in head-on collisions which represent 64% of all type of collisions. To the best of our knowledge this is the first description of hand injuries due to inflation of an air bag system. Ophthalmological (Mishler, 1991; Rimmer and Shuler, 1991) and otological (Beckerman and Elberger, 1991) injuries have been already described. It seems that no security system is free from side effects. References BECKERMAN, B. and ELBERGER, S. (1991). Air bag ear. Annals of Emergency Medicine: 20: 7: 831-832. MISHLER, K. E. (1991). Hyphema caused by air bag. Archives of Ophthalmology, 109: 12: 1635. RIMMER, S. and SHULER, J. D. (1991). Severe ocular trauma from a driver’sside air bag. Archives of Ophthalmology, 109: 6: 774.

Accepted: 18 March Dr Thierry 0

Roth,

1993 9 Ch. des Iris, 1216 Cointrin,

1993 The British

Society

for Surgery

Geneva,

of the Hand

Switzerland