Talathi Nakul S, Ganley Theodore J, Shea Kevin G, Schwend Richard M, Baldwin Keith D
The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
St. Luke's Health System, Boise, Idaho.
JBJS Rev. 2018 Dec;6(12):e9. doi: 10.2106/JBJS.RVW.18.00037.
Lawnmower injuries remain a preventable cause of serious morbidity and even mortality in children. We aimed to characterize lawnmower injuries in children and to describe reported mechanisms through a review of the literature to better understand these injuries and their prevention.
The Embase and MEDLINE databases were queried for studies pertaining to pediatric lawnmower injuries, along with manual searching of references of included studies and Google Scholar searches. Reviews and case reports were excluded. Studies relating to lawnmower injuries were broadly included to ensure capture of the relevant studies. Studies with both adult and pediatric data were included if pediatric data were granular and available for separate analysis.
Thirteen studies met inclusion criteria: 8 single-center series and 5 national database studies. Age of injury was bimodal with peak frequencies at ages 3 and 16 years. National studies estimated a mean of 11.2 injuries per 100,000 children, with 5% to 8% of patients hospitalized. Analysis of both single-center series and national database studies revealed 3 major mechanisms of injury: blade injuries, projectile injuries, and burn injuries. Blade injuries resulted in higher morbidity, with a greater need for operative management, amputation, and longer length of hospitalization. Similarly, rider mowers posed a greater injury risk than push mowers.
This systematic review of lawnmower injuries in children identified patterns and mechanisms of injuries across the literature that may serve to educate parents, policy-makers, and health-care providers as well as provide data to develop and improve prevention strategies.
割草机伤害仍是儿童严重发病甚至死亡的可预防原因。我们旨在通过文献回顾来描述儿童割草机伤害的特征，并阐述所报告的致伤机制，以更好地了解这些伤害及其预防措施。
检索了Embase和MEDLINE数据库中与儿童割草机伤害相关的研究，并手动检索了纳入研究的参考文献以及进行了谷歌学术搜索。排除综述和病例报告。广泛纳入与割草机伤害相关的研究，以确保涵盖相关研究。如果儿科数据详细且可单独分析，则纳入包含成人和儿科数据的研究。
13项研究符合纳入标准：8项单中心系列研究和5项国家数据库研究。受伤年龄呈双峰分布，高峰频率出现在3岁和16岁。国家研究估计每10万名儿童中平均有11.2例受伤，5%至8%的患者住院治疗。对单中心系列研究和国家数据库研究的分析揭示了3种主要致伤机制：刀片伤害、投射物伤害和烧伤。刀片伤害导致更高的发病率，对手术治疗、截肢的需求更大，住院时间更长。同样，骑乘式割草机比推式割草机造成的伤害风险更大。
这项对儿童割草机伤害的系统评价确定了文献中伤害的模式和机制，这可能有助于教育家长、政策制定者和医疗保健提供者，并为制定和改进预防策略提供数据。
