INJURIES OF THE FOOT RELATED TO THE USE OF LAWN-MOWERS

We managed thirty-three patients who had open injuries of the foot related to the use of a lawn mower from 1985 through 1992. Twenty-eight of the patients were male and five were female. They ranged in age from four to seventy-three years old. The injuries were associated with the use of push lawn mowers (twenty-two patients), riding lawn mowers (nine patients), and self-propelled lawn mowers (two patients). The injuries included forty open fractures, twenty amputations, eighteen lacerations of the skin and nail beds, nine lacerations of tendons, two dosed fractures, segmental loss of bone in two patients, acid segmental loss of the Achilles tendon in one patient. The findings on culture of intraoperative specimens revealed a mean of 3.1 organisms (range, one to nine organisms) per patient. All of the patients were managed with at least one operative procedure (mean, 2.4 operations; range, one to five operations), and all were treated with parenteral antibiotic therapy (mean, 2.3 antibiotics; range, one to six antibiotics) except for one patient who had oral antibiotic therapy. The mechanism of injury was documented for twenty of the twenty-two patients who had been injured by a push lawn mower, Seventeen patients were injured while pulling the push fawn mower backward, and eight of those patients had been pulling the lawn mower up a slope. One of the two patients who were injured by a self-propelled lawn mower had been pulling the lawn mower backward up a slope. Seven of the nine patients who were injured by a riding lawn mower were children. Six of the children were injured when the riding lawn mower was backed over them (three had been playing in the yard, and three had fallen off the riding lawn mower), and one child had been run over as she ran around the corner of a house. We do not recommend pulling any lawn mower backward, particularly on a slope, or allowing children to ride on riding lawn mowers. Furthermore, the entire mowing area must be kept free of debris at all times and no one else should be allowed in the area while it is being mowed. Safety standards for wall-behind (push and self-propelled) and riding mowers were implemented in June 1982 and July 1987, respectively. We recommend that operators be familiar,vith the safety features of their lawn mowers and follow all safety standards set forth to prevent injuries. Also, it remains the responsibility of the operator to mow in the correct manner and to clear the mowing area of all objects, children, and pets.