Dahlin Lars B, Ljungberg Elinor, Esserlind Ann-Louise
Department of Hand Surgery, Malmö University Hospital, Malmö, Sweden.
Scand J Plast Reconstr Surg Hand Surg. 2008;42(1):43-7. doi: 10.1080/02844310701667221.
Fourteen children (median age 43 months, range 14-82 months; 7 girls and 7 boys) were treated for mangle injuries (one hot steam, and 13 cold roller presses) to the hand and forearm between 1996-2002 at the Department of Hand Surgery, Malmö, Sweden. All children had unilateral skin damage with avulsion or necrosis of skin in nine. Seven of the 14 had signs of compartment and carpal tunnel syndromes and three had fractures (phalanges or hamate bone). Initial treatment included fasciotomy, decompression, and skin revision with split skin grafts and later further skin cover, including one pedicled ulnar flap. IN eight the injuries healed uneventfully, while six had slight consequences (such as minor extension deficit of fingers or slight contracture of the scar). Ten of the 14 children came from immigrant families. Mangle injuries can be prevented through better supervision of children by parents when the mangle is being used, and dissemination of information of the potential hazards in relevant languages in residential areas with large immigrant populations.
1996年至2002年期间,瑞典马尔默手外科收治了14名儿童(中位年龄43个月,范围14 - 82个月;7名女孩和7名男孩),他们的手和前臂遭受了碾压伤(1例热蒸汽伤,13例冷滚筒挤压伤)。所有儿童均为单侧皮肤损伤,其中9例伴有皮肤撕脱或坏死。14例中有7例出现骨筋膜室综合征和腕管综合征体征,3例有骨折(指骨或钩骨)。初始治疗包括筋膜切开减压、皮肤清创及中厚皮片移植,后期进一步行皮肤覆盖,包括1例带蒂尺侧皮瓣。8例患儿伤口愈合顺利,6例有轻微后遗症(如手指轻度伸展受限或瘢痕轻度挛缩)。14名儿童中有10名来自移民家庭。通过家长在使用碾压机时加强对儿童的监管,并在移民人口众多的居民区用相关语言传播潜在危害信息,可预防碾压伤。