Sugarcane crusher–related hand injuries: a clinical study with functional outcomes and preventive insights

Occupational hand trauma remains a major source of disability, particularly among informal workers exposed to unsafe machinery. Sugarcane juice extraction machines are an underrecognized cause of severe crush injuries in India, especially during the summer season when roadside vending activity is high. This prospective descriptive case series included patients presenting with sugarcane crusher–related hand injuries to the Department of Trauma and Emergency Medicine at a tertiary care center between January 2025 and December 2025. Demographic details, injury characteristics, treatment, complications, and short-term functional outcomes were recorded. Patients were managed according to standard trauma principles, followed by wound debridement, primary repair with or without fracture fixation as required, splinting, and rehabilitation. Early functional outcome was assessed using the QuickDASH score at 3 months. Twelve patients were included, most of them were in the age group of 25–35 years and most of the patients were male. All the patients had injuries involving the dominant hand. Ten patients sustained typical roller-crush injuries, whereas two had atypical injury patterns. Early presenters were generally managed with debridement, primary repair, splinting, and selective fracture fixation. Amputation was considered only in cases of non-salvageable tissue damage. The QuickDASH score at 3 months follow up showed excellent functional recovery in most cases. Postoperative complications occurred in four patients, with stiffness being the commonest. Sugarcane crusher injuries are serious but largely preventable occupational hand injuries. Early intervention and structured rehabilitation can produce favorable short-term outcomes but emphasis on machine safety, operator education, and preventive regulation is needed.