EXTREMITY LAWN-MOWER INJURIES IN CHILDREN - REPORT BY THE RESEARCH COMMITTEE OF THE PEDIATRIC ORTHOPEDIC SOCIETY OF NORTH-AMERICA

In a multicenter study of pediatric lawn-mower injuries (push or ridin g gas-powered machines), we reviewed 144 children at an average age of injury of 7.0 years; 77% were boys. Most injuries (92 of 104) occurre d in the afternoon. The child was the machine operator in 36 cases, a bystander in 84, and a passenger in 21. The average hospital stay was 13.3 days with 2.6 surgeries per child, Amputations occurred in 67 chi ldren; 63 were unilateral and four bilateral; the most common level wa s the toes (63%). Blood transfusions were given to 35 children. Childr en injured by riding lawn mowers, when compared with those by push law n mowers, were younger (5.4 vs. 11.0 years),less frequently the operat or (15 vs. 60%), had longer hospitalizations (15.0 vs. 8.9 days), and required more surgeries (3.0 vs. 1.6) and blood transfusions (41 vs. 3 %). Children with free flaps needed more transfusions (78 vs. 26%), an d transfused children were younger (4.6 vs. 8.1 years), more likely to be bystanders (91 vs. 63%), required more surgeries (4.1 vs. 2.0), an d were hospitalized longer (21.6 vs, 9.7 days). Soft-tissue infections occurred in eight of 118 and osteomyelitis occurred in six of 117 chi ldren. Al an average follow-up of 1.9 years, there were 43 satisfactor y and 84 unsatisfactory results. When excluding those children with am putations of digits, there were 42 satisfactory and 47 unsatisfactory results. If children younger than 14 years had not been permitted arou nd lawn mowers, similar to 85% of the injuries in this report would ha ve been prevented. Further public dissemination of the following infor mation is needed: (a) children younger than 14 years should not operat e lawn mowers, (b) children younger than 14 years should not be in the yard while the lawn is being mowed, and (c) no passengers, regardless of age, should be allowed on riding mowers.