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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Case Series
Full Version
Motorcycle Chain Entrapment Injuries to the Hand during Routine Maintenance: A Case Series
Correspondence Address :
Manimaran Ramachandran,
Associate Professor, Department of General Surgery, Sree Balaji Medical College, Chennai-600044, Tamil Nadu, India.
E-mail: manimaran.r@sbmch.ac.in
Motorcycle-related hand injuries are commonly associated with road traffic collisions; however, injuries sustained during routine chain cleaning and lubrication remain underreported despite being entirely preventable. This case series included 14 consecutive patients treated between April 2025 and December 2025. All patients were male, with a mean age of 29.6 ± 10.8 years (range 17-55 years). The dominant hand was involved in 9 (64.3%) patients, while injury laterality showed right-hand involvement in 10 (71.4%) and left-hand involvement in 4 (28.6%) patients. The index finger was most commonly affected in 5 (35.7%) cases, followed by the middle finger in 4 (28.6%) cases. All 14 (100%) patients presented with contaminated wounds. Definitive management included primary closure in 4 (28.6%) patients, local flap reconstruction in 3 (21.4%), split-thickness skin grafting in 1 (7.1%), tendon repair in 2 (14.3%), Kirschner wire fixation in 2 (14.3%), and revision amputation in 2 (14.3%). Postoperatively, superficial wound infection occurred in 2 (14.3%) patients and resolved with conservative management, while mild residual stiffness was observed in 3 (21.4%) patients. No cases of deep infection, osteomyelitis, flap or graft failure, or major limb compromise were noted. Complete wound healing was achieved in all patients. Motorcycle chain entrapment injuries represent a preventable yet clinically significant cause of hand trauma in young males. Early irrigation, prompt debridement, and defect- specific reconstruction are associated with favourable outcomes and minimal complications.
Case series, Contaminated wound, Crush-avulsion injury, Fingertip amputation, Hand trauma, Motorcycle chain injury, Soft-tissue reconstruction, Tendon injury
Road traffic injuries remain a major global public health concern, particularly among young and economically productive populations. The World Health Organisation reports that road traffic trauma is a leading cause of mortality worldwide, with a disproportionately higher burden in low- and middle-income countries where two- wheelers constitute a primary mode of transport (1). While most literature focuses on collision-related trauma, preventable injuries associated with vehicle maintenance practices remain under-recognised. Among these, motorcycle chain entrapment injuries represent a neglected yet entirely preventable cause of hand trauma (2).
Motorcycle chain entrapment injuries occur when fingers are caught between the rotating chain and sprocket, producing combined crush, traction, and rotational forces (3).
This case series included 14 consecutive patients treated between April 2025 and December 2025. All patients were male (14, 100%), with a mean age of 29.6±10.8 years (range 17-55 years). The dominant hand was defined as the hand preferentially used for daily activities such as writing and feeding. The dominant hand was involved in 9 (64.3%) patients. Injury laterality showed involvement of the right hand in 10 (71.4%) patients and the left hand in 4 (28.6%) patients. Dominant-hand involvement and injury laterality were analysed as separate variables. Therefore, injury laterality (right or left hand) should not be interpreted as directly corresponding to dominant- or non-dominant-hand involvement (Table/Fig 1).
The index finger was the most commonly involved digit in 5 (35.7%) patients, followed by the middle finger in 4 (28.6%) patients, with involvement of other digits and multiple digits observed less frequently (Table/Fig 2).
All patients (14, 100%) sustained contaminated injuries, predominantly presenting as crush-avulsion soft-tissue damage. Structural involvement included tendon injury in 2 (14.3%) patients, phalangeal fractures in 2 (14.3%), and distal fingertip amputations in 2 (14.3%) (Table/Fig 3).
The total number of procedures exceeds the total number of patients because some patients underwent more than one procedure during the same treatment episode.
All patients underwent early wound irrigation and surgical debridement. Minor injuries without significant tissue loss were managed conservatively in 1 (7.1%) patient, while primary closure was performed in 4 (28.6%) patients with clean, well-vascularised wound margins. Local flap reconstruction was required in 3 (21.4%) patients with exposed tendon or bone, and split-thickness skin grafting was performed in 1 (7.1%) patient with superficial soft-tissue defects (Table/Fig 4). Some patients required combined reconstructive and skeletal or tendon procedures; therefore, the total number of procedures recorded exceeded the total number of patients treated.
Tendon repair was undertaken in 2 (14.3%) patients with documented tendon disruption, and K-wire fixation was performed in 2 (14.3%) patients with associated phalangeal fractures. Revision amputation was required in 2 (14.3%) patients with non-salvageable distal fingertip injuries, while delayed closure was performed in 1 (7.1%) patient due to heavy contamination (Table/Fig 4).
Postoperatively, superficial wound infection occurred in 2 (14.3%) patients, both of whom resolved with conservative management. Mild residual stiffness was observed in 3 (21.4%) patients, particularly in those with tendon involvement. No cases of deep infection, osteomyelitis, flap or graft failure, or major limb compromise were recorded. Complete wound healing was achieved in all patients. Minor fingertip laceration is shown in (Table/Fig 5).
Intraoperative sequence demonstrating cross-finger flap reconstruction for coverage of a distal digital defect following motorcycle chain crush–avulsion injury. The images show defect assessment, flap elevation from the adjacent finger, inset of the flap, and postoperative coverage of exposed tissue (Table/Fig 6).
Clinical and intraoperative images illustrating primary closure of a traumatic fingertip laceration following wound debridement. The defect margins were approximated with interrupted sutures after adequate irrigation and removal of devitalised tissue (Table/Fig 7).
Operative photographs showing palmar split-thickness skin graft harvesting and graft placement for reconstruction of a soft-tissue defect after debridement of crushed tissue. The graft provides secondary coverage to restore skin continuity and protect underlying structures (Table/Fig 8).
In the present series of 14 patients, all injuries were contaminated (100%), complete wound healing was achieved in all cases (100%), superficial infection occurred in two patients (14.3%), and no deep infection (0%) or major limb compromise was observed.
Consistent with our findings, previous research on 136 motorbike chain-related fingertip injuries reported a predominance of young adult males (mean age 29 years), with the right hand more frequently involved (74.3%). The index and middle fingers were the most commonly affected digits, and Allen type III injuries accounted for nearly half of all cases (46.3%). V-Y plasty was the most frequently utilised reconstructive procedure (35.3%) (4).
Karahan G et al., highlighted that motorcycle chain injuries predominantly affect young males (5). This is consistent with our cohort, in which 100% of patients were male, with a mean age of 29.6 years.
Ilavarasan S et al., emphasised that management strategies in fingertip injuries must be individualised, ranging from conservative care to flap reconstruction (6). This is consistent with our approach, in which treatment was tailored to tissue loss.
Replantation of fingertip amputations in crush injuries remains controversial. Ishikawa K et al., reported replantation success rates of up to 80% in selected cases, primarily in clean-cut injuries (7). However, in crush-contaminated injuries such as those seen in our cohort, outcomes are less predictable.
In a case series by Singh S et al., out of 15 young patients with finger or hand crush injuries caused by motorcycle chains or machine gear systems, replantation or revascularisation was attempted in all cases. Successful salvage was achieved in nine patients (60%), while six patients (40%) experienced failure of revascularisation, resulting in loss of the injured digit (8).
A study of motorcycle chain-related amputations reported an 83.3% survival rate following replantation (5/6 cases), with no infection-related complications and favourable functional outcomes, including return to work within three months (9).
Overall, when compared with available literature, our study demonstrates that despite 100% contamination and complex injury mechanisms, outcomes can be optimised with early intervention, resulting in 100% healing, low superficial infection (14.3%), and zero deep infection or limb loss.
Motorcycle chain entrapment injuries represent a rare yet entirely preventable form of contaminated hand trauma, predominantly affecting young males during routine self-maintenance activities. Overall, this series demonstrates that while motorcycle chain entrapment injuries are inherently severe due to their mechanism, favourable outcomes can be consistently achieved through early, structured management combined with preventive strategies aimed at reducing exposure to this avoidable risk.
DOI: 10.7860/JCDR/2026/89006.24294
Date of Submission: Mar 16, 2026
Date of Peer Review: Apr 06, 2026
Date of Acceptance: Jun 19, 2026
Date of Publishing: Sep 01, 2026
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Mar 25, 2026
• Manual Googling: Jun 15, 2026
• iThenticate Software: Jun 17, 2026 (1%)
ETYMOLOGY: Author Origin
EMENDATIONS: 7
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
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- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com