Grain auger injuries: the replacement of the corn picker injury?

Corn picker injuries, although more infamous, are less frequent than those produced by the grain auger. The former rarely occurs in other than adult males who are responsible for their carelessness, whereas the grain auger injury frequently involves innocent and uninformed youths. We report 4 arms, 4 forearms, 5 hands, 24 digits, 2 legs, 4 feet, and 4 toes injured by a grain auger in 24 patients. Multiple-level injuries accounted for the larger number of injuries than patients. Twelve amputations or devascularizations were reattached or revascularized successfully. Not all amputations had attempts at reattachment because of the severe crushing of the part and/or stump that was present in all patients to varying degrees. All wounds were heavily contaminated and were treated with voluminous irrigation and adequate debridement. Serial debridements were needed prior to coverage in several patients. Prevention is the best treatment, but given early aggressive care, many injured can regain a high level of function.