Elevator Injuries: Reconstructive Challenge

Introduction: Escalator and elevator injuries are injuries related to industrialisation and urbanisation of life. The shift of the population from villages to city has led to increase in numbers of high-rise buildings which are more than 10 storied high. High rise buildings more than twenty or thirty storeys are routinely seen in metropolitan cities. All these high rise needs Elevator to go up and down to reach home or office. There are many skyscrapers more than 100 storeyed in this world where fast elevators are used like CN Towers, Burj Khalifa, Tapie 101 etc. The elevators used are very fast, but speed always comes with technical problems and accidents. So human beings have to pay the price of this development. Material & Methods: This article is a case series of fifteen patients, who had sustained hand injury while using elevator. These injuries are simple CLW, crush injuries, degloved injuries, avulsion injuries of hand or near total to total amputation of fingers tips, fingers including thumb, palm, wrist or elbow. Crush or degloved injury needed debridement and flap coverage, while near total amputation needed revascularisation and flap coverage or skin grafting. While Total amputation needed replantation and coverage. Results and Observation: These injuries result in bigger zone of trauma and post-operative results vary and depend upon the type of injury crushing or degloved, mechanical force and power of accident, vascularity of distal limb and management of wound. Conclusion: With the recent technical advancement in wound management and availability of microvascular surgery now it is possible to save the limbs by using various flaps or replantation or revascularisation of amputated limbs. With addition of physiotherapy it’s possible to regain near normal lifestyle. But in the end, it’s advisable to follow the general guidelines and not to overlook safety protocols to avoid any type of elevator Injury.