Objective: To review a series of ax injuries of the hand.
Design: Retrospective epidemiological review of 125 cases.
Materials: Assessment from the notes of all injuries, with more detailed follow-up of 26 cases.
Measurements: Levels of injury, surgery required, complications, results, patient satisfaction, methods of prevention.
Conclusions: Ax injuries are rare. They usually affect the thumb and index finger of the nondominant hand. As with all hand injuries, expertise in dealing with bone, tendon, nerve, and skin cover is essential. Even "minor" injuries may give rise to considerable morbidity. Our complication rate in replantation was 50%. Care should be taken here not to compromise the result by attempting to maintain the length of the bony skeleton. The long-term results (at 11 months to 12 years) were generally satisfactory, but cold intolerance may persist for many years. As with all accidents, prevention would be better than cure. Neither we nor the patients could think of any way of significantly reducing the incidence of these accidents. However, holding the ax by the neck seemed a common way of sustaining injury.