Wringer washing machine injuries: criteria for obtaining radiological studies.

While the number of wringer washing machine injuries is declining due to the increasing use of automatic washing machines, these injuries still occur. Historically, children with wringer injuries received routine radiographs to diagnose fractures, in spite of the low fracture rate in wringer injuries. Review of the records at Milwaukee Children's Hospital between the years 1973 and 1983 revealed that of the 99 wringer injuries seen, 80 of 99 patients were radiographed and only five fractures were diagnosed. Of these fractures only two were attributable to the wringer device and these two required therapy. Criteria are developed to identify which patients should undergo radiologic studies. Using the criteria of localized pain or tenderness, crepitation, obvious deformity, or abnormal movement in the extremity, the two serious fractures would have been identified, and these two patients would have been radiographed. The other 78 patients would not have been radiographed.