Teen regains full mobility in hand after fireworks accident

Tanner Staff was like many 15-year-old boys his age who played football and enjoyed duck hunting and fishing. His passion was spending time in the agriculture shop at school doing welding projects. A traumatic New Year’s Eve accident almost caused Tanner to lose his right hand – the one used to hold a hammer and football for his favorite activities.

It was a cold and windy night when Tanner and his friends decided to celebrate New Year’s Eve lighting fireworks. In an unfortunate moment, the fireworks went off too early and hit Tanner’s hand. The explosion caused his eyes to bleed and tore holes in his eardrums. Tanner took the brunt of the blast, since he was standing in front of his friends.

“The blast was so big that my friends fell to the ground,” Tanner said. “I couldn’t see or hear anything, so I didn’t know. I got up and felt my right hand with my left hand and knew something was wrong.”

Tanner’s friends took him to the emergency room in El Campo, Texas. An air ambulance in Houston was already called and in route before Tanner’s parents even arrived to the ER.

Tanner’s mom, Amy Staff, said Tanner was in shock, because his friends said he opened the truck door with his right hand. That doesn’t sound possible considering his injuries. The first two fingers on his right hand were burned completely. His middle finger was missing skin, his thumb was hanging broken, and his palm torn open completely with nerve damage throughout his hand.

Ashton Mansour, MD, orthopedic hand surgeon with UT Physicians and assistant professor in the Department of Orthopedic Surgery at McGovern Medical School at UTHealth Houston, was on call and came to the hospital early the next morning to see Tanner. He discovered a severe firework injury with significant soft tissue loss, bone damage, nerve/tendon/artery damage, loss of skin, severe burns, and a grossly contaminated wound.

“When you have an explosion, it sends debris at high speeds into the tissue, and the tissue gets grossly contaminated,” Mansour said. “To get that out is a very difficult challenge, on top of trying to leave enough tissue to protect the vital structures in the hand.”

Unfortunately, Tanner’s injury was one of five fireworks injuries Mansour saw from New Year’s Eve. Mansour’s team treats a significant number of injuries after holidays involving fireworks.

Mansour’s initial prognosis was potentially amputating Tanner’s hand, but he would try to save his pinky and thumb. If that was the case, Tanner decided he’d rather lose his whole hand.

“We were hoping for the best, but Dr. Mansour wasn’t promising anything,” Amy said. “He said possibly 25%-50% movement, but if infection set in, it still might have to be removed.”

Tanner’s surgery with Mansour lasted 8 ½ hours and ultimately required nine screws and four pins. Much of the time involved debridement, which is removing dead and dying tissue. After the wound was as clean as possible, Mansour began to stabilize the bones.

Mansour was able to save the hand and put it back together as best he could, but there was still a high risk of infection for months. He continued to repair soft tissue injuries with skin advancement flaps by rearranging the skin to cover tendons, nerves, and bones. Tissue damage to Tanner’s index finger ultimately resulted in Mansour amputating the tip of the finger, but the skin healed up well, he said.

Tanner began physical therapy two weeks after the accident. The family opted to do therapy at home and take the hour-long trip to the clinic only once a week. Home therapy was not an easy schedule. Three times a day, Tanner’s parents would carefully unwrap his hand, help him with mobility movements to gain flexibility, clean it, and then wrap it back up. That process lasted two to three months until the bandage came off. When the wrap came off, they still continued doing therapy for months. Originally, the therapist doubted Tanner would have full use of his hand and would be lucky to regain 50% movement. Tanner’s goal was to swing a hammer again, but they weren’t sure he could get that much mobility. Tanner actually regained 100% mobility and has a fully functioning hand.

“The therapists say he’s a true miracle. There were lots of tears and crying to get the therapy done,” Amy said. “My husband and I took turns throughout the day. You basically hurt him to help him.”

Mansour believes Tanner’s family support system played a huge role in his successful outcome.

“Tanner had great therapy, but mostly he had great family support,” Mansour said. “They worked diligently with him and made a huge difference in his prognosis. I tip my hat to them.”

It takes a significant amount of therapy, Mansour continued, and most people can’t get that amount because it’s expensive and time-consuming. Tanner has a great functioning hand for the severity of his injury, he said, due to that support.

Tanner never felt hopeless, despite his traumatic injury and initial prognosis.

Tanner’s mom remembers the feeling when he was flown to Houston. She said she prayed the whole way to Houston as they drove more than an hour from El Campo.

“It was a long night but well worth the wait, because God answered all my prayers when he placed Dr. Mansour in our path,” Amy said. “We are forever grateful for him.”