195 Hand Injuries in 12 Days: The Outcomes of the Feast of Sacrifice

DEAR EDITOR The feast of sacrifice is a muslim tradition, celebrated by the muslims all around the world. Every year during the month of pilgrimage to Mecca (Hajj), the feast of sacrifice is celebrated. One specific part of this feast is to sacrifice animals such as sheep and cattle in the first three days of the feast. Most of the sacrifices were performed in the streets by non-professionals without proper security precautions.1 Cutting tools such as knives, cleavers and meat grinders are common tools both for sacrificing animals and processing the animal meat afterwards. As a result of mentioned reasons, plenty of accidental injuries occur during the feast of sacrifice. Hand injuries constitute the majority of these injuries. The aim of this study was to determine the rate of injuries in the first three days of the feast of sacrifice. A total of 195 hand injuries occured in the first three days of the feast of sacrifice in four consecutive years (2011-2014) were enrolled. Patients who needed surgical intervention were included. The patients who were treated wtih primary skin suture and nonsacrifice related injuries and those who had multiple traumas with hand injuries were also excluded from the study. Patients were evaluated for age, gender, injury type, injury location and cause. There were 169 male and 26 female patients. The average age was 38.1 (3–84) years. The average age of female patients (35.6 years) was slightly younger than the male patients (38.5 years). Three types of tools were responsible for all injuries. The most common tool was knife (171 injuries) followed by cleaver (19) and the third one was the meat grinder (5). Ninety seven patients attended the ER in the first day of the feast, 58 patients attended the second day and 40 patients attended the third day. A total of 215 anatomical structures were injured, while 146 (67%) were between metacarpophalangeal (MCP) joint and finger tip, 22% were between wrist and MCP joint and 24 injuries 11% were in the forearm. The extensor tendons were the most commonly injured structures (47%). Flexor tendon injuries with or without neurovascular bundle damage were the second most commonly injuries (18%), followed by distal phalangeal amputations (18%) and phalangeal fractures (16%). Extensor tendons were also the most commonly injuried structrures in the hand (zone V and VI) with 39 out of 44 injuries (89%). There were 5 palmar injuries and only one metacarpal fracture. In the forearm, flexor side injuries were dominant. Twenty one injuries out of 24 were located in the flexor side in the forearm. There were only 3 injuries in the dorsal side. Letter to Editor