• Mark J C Smeulders, Ramon R Gorter, Huib A Cense, and A Toine van Trier.
• Academisch Medisch Centrum, afd. Plastische, reconstructieve en handchirurgie, Amsterdam.
• Ned Tijdschr Geneeskd. 2013 Jan 1; 157 (49): A6827.

BackgroundFireworks injuries are common and often affect children. Such injuries should be considered high energy trauma in the emergency room and taken care of according to the principles of the Advanced Trauma Life Support (ATLS).Case DescriptionA 7-year-old boy was a victim of an explosion when he set off illegal fireworks. During evaluation in the emergency department he presented with a superficial laceration on the belly and extensive hand injury. Upon examination he had small-intestinal perforation that required immediate resection. The patient recovered well, but suffered permanent damage to the hand.ConclusionPotentially life threatening injuries may accompany hand injuries after modern illegal fireworks. Hand injuries are serious. Despite prolonged treatment, they often result in permanent disability. The structured approach to trauma according to ATLS was important in detecting an accompanying abdominal trauma in this case.

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