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Machete injuries to the upper extremity

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

We intend to describe and analyze the spectrum of upper extremity injuries that arises from both accidental and intentional machete injuries with a focus on associated complications and comorbidities. This review is the first from a United States institution, and the only from a designated level 1 trauma center.

Methods

A retrospective review of machete related upper extremity injuries admitted to a level 1 trauma center from 2008 to 2016. The following data was collected on admitted patients: demographics, mechanism of injury, surgical management, and complications. We assessed the data with Pearson Chi square analysis.

Results

This cohort consisted of 48 patients (mean = 42 ± 13 years old); the majority were men (96%) involved in an assault (81%). These patients had a high rate of documented psychiatric history, substance and tobacco abuse, and being underinsured. Patient follow-up was extremely variable: 75% of patients presented for follow-up care (mean = 149 ± 344 days; range 8–1846 days). 44% had complications (i.e., infection, tendon rupture, nerve palsy). We identified no associations when examining follow-up rates or complication rates regarding patient comorbidities, insurance status, mechanism of injury, or the need for a nerve, artery, or tendon repair. Patients with current tobacco use did have an increased risk for infection. The majority (52%) of injuries occurred on the ulnar side of the forearm and to the non-dominant extremity (66%). Patients assaulted by machetes are significantly more likely to have a history of psychiatric illness, substance abuse, tobacco use, and are more likely to be underinsured compared to those with accidental machete injuries.

Conclusions

While machete injuries may be uncommon in most areas of the United States, physicians should give special attention to the patient comorbidities as many of these patients have complex medical and social issues which could complicate attempts of appropriate treatment.

Level of evidence

IV; Prognostic Study.

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Authors and Affiliations

  1. Department of Orthopedics, Jackson Memorial Hospital, 1611 N.W. 12th Avenue, Miami, FL, 33136-1096, USA

    Chester J. Donnally III, William Hannay, Derek A. Rapp, Nikola Lekic & Seth D. Dodds

Authors
  1. Chester J. Donnally III
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  2. William Hannay
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  3. Derek A. Rapp
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  4. Nikola Lekic
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  5. Seth D. Dodds
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Corresponding author

Correspondence to Chester J. Donnally III.

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Conflict of interest

The authors declare that they have no conflict of interest.

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There is no funding source.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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For this type of study, formal consent is not required.

Additional information

All authors significantly contributed to the document and have reviewed the final manuscript.

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Donnally, C.J., Hannay, W., Rapp, D.A. et al. Machete injuries to the upper extremity. Arch Orthop Trauma Surg 137, 1615–1621 (2017). https://doi.org/10.1007/s00402-017-2783-y

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  • DOI: https://doi.org/10.1007/s00402-017-2783-y

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