title: Management of lawn mower injuries to the foot and ankle.
abstract: Seventy consecutive patients treated for lawn mower injuries to the foot and ankle were reviewed to determine optimal treatment, functional results, and complications. Injuries were classified into 1 or more functional-anatomical zones (I, digits; II, dorsum; III, plantar nonweight-bearing surface; IV, heel; and V, ankle) for a total of 96 injuries. Thirty-one patients were available for follow-up. Mean age was 36.7 years and 84% were males. Most injuries (67%) involved patients > 16 years old using a push mower; however, 18% involved children < 5 years old, usually caused by riding mowers (70%). Primary closure after adequate irrigation and debridement was the preferred method of treatment except in patients with Zone IV injuries. Antibiotic prophylaxis was used in almost all injuries (93%). A 100% ambulation rate was achieved with 10% of patients requiring a prosthesis. Zone IV (heel) injuries had a 50% complication rate from chronic soft tissue breakdown. The wound infection rate per injury was 12.5% and did not vary significantly between closed (11.4%) and open (17.6%) treatment. Lawn mower injuries to the foot and ankle can be closed primarily after adequate irrigation and debridement without compromise of infection rate or function. Antibiotic prophylaxis is recommended. One-sixth of these injuries involve children < 5 years of age and can be prevented.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Southern Illinois University School of Medicine, Springfield 62794-9230.
authors.forename: J
authors.initials: J
authors.lastname: Corcoran
authors.forename: W A
authors.initials: WA
authors.lastname: Zamboni
authors.forename: E G
authors.initials: EG
authors.lastname: Zook
mesh_terms: D000061:Accidents, Home / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000209:etiology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003646:Debridement; D005260:Female; D005528:Foot / Q000601:surgery*; D018409:Foot Injuries; D006801:Humans; D008297:Male; D007507:Therapeutic Irrigation