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Editor,—Working in accident and emergency (A&E), we are used to patients presenting with injuries sustained during punching. Some of these injuries are sustained by people while in nightclubs, and almost invariably the “punch” is not welcomed by the nightclub management. We wish to highlight the case of a 17 year old youth who sustained punch injuries in a Cornish nightclub, but whose punching was encouraged by the management! Having put money into a newly introduced coin operated punchbag machine, he punched the bag three times with his right fist and once with his left, then felt pain in both wrists. During his attendance at A&E the following day, clinical suspicion of scaphoid fractures was confirmed radiologically: he had obvious bilateral fractures through the waists of both scaphoids. With the patient's permission, we reported the injuries back to the nightclub management, who have taken the machine out of action, while they “investigate” and consider if and how they can make it safer. We are aware of anecdotal reports of injuries sustained while punching these machines elsewhere in the United Kingdom. Clearly, in the setting of a nightclub, the combination of alcohol and peer group pressure may conspire to produce significant injuries. Owners of nightclubs need to be aware of the risks of their machines, so that they can take measures to reduce these risks.
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