Etiology of Children's Traumatic Amputations and Lawn Mower Injuries
KARL F. FRANKOVITCH, MD**, AND MARK STENCLIK, MDErie, Pennsylvania
Ten years' experience with lower-limb traumatic amputations, comprising 50 patients, was reviewed. Etiology was approximately equally divided into those amputations caused by heavy machinery, i.e. trains, autos,, and farm equipment, and those caused by lawn mowers. The heavy machinery population was older and had major injuries, with the level of amputation being evident at time of injury. Complications were related primarily to short residual limbs and poor skin coverage which were handled by prosthetic adaptations and local and free flap transfer. In contrast, lawn mower injuries usually were partial amputations and complex in nature, affecting a much younger population. Complications were varied and often progressive, including terminal overgrowth, growth arrest or angulation, meager soft tissue coverage, tendon imbalance, infections, spur formation, and nerve laceration. The problems resulted in a high revision rate, often multiple in the same patient. An individual approach with careful follow-up by both prosthetist and surgeon was required throughout the growth period. The few patients that had direct conversion to a Boyd amputation required no revision.
**Shriners Hospital for Crippled Children, 1645 West 8th Street, Erie, PA 16505