title: Lower limb trauma caused by power-driven cultivators: report of 23 cases.
abstract: OBJECTIVE
  To determine the mechanism and the severity of injuries caused by power-driven cultivators.
  
  
  METHODS
  This retrospective study analyzed the clinical records of 20 patients treated from 1984 to 1996 for a total of 23 lower limb injuries caused by power-driven cultivators (three patients had bilateral injuries) in the Nice University Hospital.
  
  
  RESULTS
  A total of 90% of the accidents occurred when the machine was put into reverse and the limb was caught by the rotary blades; the cause of the remaining accidents was unknown. Of the 23 patients, 10 patients (43.5%) suffered posterior dislocation of the knee due to forced hyperextension. Injuries were classed in two groups as a function of their prognosis: group I consisted of osteomuscular lesions without vascular or nerve involvement (11 lower limbs, 11 patients). The mortality rate in this group was 9%, the rate of major amputation was 18%, and the prognosis was favorable in 82% of the cases. Group II corresponded to lower limb injuries with neurovascular involvement (12 lower limb injuries in 10 patients: one patient belonged to both group I and group II). Acute lower limb ischemia was constant in group II; the mortality rate was 20% (two of 10 patients), and the rate of major amputation was 41.6% (five of 12 patients; three emergency amputations and two secondary amputations).
  
  
  CONCLUSIONS
  These agricultural machines can cause severe trauma, and the resulting wounds are contaminated by telluric germs in rural areas. Paradoxically, power-driven cultivators are not legally classified as "dangerous machines." Modification of existing legislation in this field would seem advisable.
authors.affiliation: Service de Chirurgie Vasculaire, Hôpital Saint-Roch, Nice, France.
authors.forename: P
authors.initials: P
authors.lastname: Baqué
authors.forename: C
authors.initials: C
authors.lastname: Trojani
authors.forename: M
authors.initials: M
authors.lastname: Batt
authors.forename: R
authors.initials: R
authors.lastname: Hassen-Khodja
authors.forename: H
authors.initials: H
authors.lastname: Bariseel
authors.forename: P
authors.initials: P
authors.lastname: Pittaluga
authors.forename: S
authors.initials: S
authors.lastname: Declémy
authors.forename: B
authors.initials: B
authors.lastname: Prate
authors.forename: P
authors.initials: P
authors.lastname: Le Bas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000383:Agriculture / Q000295:instrumentation* / Q000706:statistics & numerical data; D000673:Amputation, Traumatic; D005260:Female; D005602:France; D006801:Humans; D015601:Injury Severity Score; D007869:Leg Injuries / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D012189:Retrospective Studies