Corcoran J, Zamboni W A, Zook E G
Division of Plastic and Reconstructive Surgery, Southern Illinois University School of Medicine, Springfield 62794-9230.
Ann Plast Surg. 1993 Sep;31(3):220-4. doi: 10.1097/00000637-199309000-00003.
Seventy consecutive patients treated for lawn mower injuries to the foot and ankle were reviewed to determine optimal treatment, functional results, and complications. Injuries were classified into 1 or more functional-anatomical zones (I, digits; II, dorsum; III, plantar nonweight-bearing surface; IV, heel; and V, ankle) for a total of 96 injuries. Thirty-one patients were available for follow-up. Mean age was 36.7 years and 84% were males. Most injuries (67%) involved patients > 16 years old using a push mower; however, 18% involved children < 5 years old, usually caused by riding mowers (70%). Primary closure after adequate irrigation and debridement was the preferred method of treatment except in patients with Zone IV injuries. Antibiotic prophylaxis was used in almost all injuries (93%). A 100% ambulation rate was achieved with 10% of patients requiring a prosthesis. Zone IV (heel) injuries had a 50% complication rate from chronic soft tissue breakdown. The wound infection rate per injury was 12.5% and did not vary significantly between closed (11.4%) and open (17.6%) treatment. Lawn mower injuries to the foot and ankle can be closed primarily after adequate irrigation and debridement without compromise of infection rate or function. Antibiotic prophylaxis is recommended. One-sixth of these injuries involve children < 5 years of age and can be prevented.
回顾了连续70例因割草机导致足踝部损伤的患者，以确定最佳治疗方法、功能结果及并发症情况。损伤被分为1个或更多功能 - 解剖区域（I区，趾部；II区，背侧；III区，足底非负重面；IV区，足跟；V区，踝关节），共计96处损伤。31例患者可供随访。平均年龄为36.7岁，84%为男性。大多数损伤（67%）涉及16岁以上使用推式割草机的患者；然而，18%涉及5岁以下儿童，通常由乘骑式割草机导致（70%）。除IV区损伤患者外，充分冲洗和清创后一期缝合是首选治疗方法。几乎所有损伤（93%）均使用了抗生素预防。行走率达100%，10%的患者需要假体。IV区（足跟）损伤因慢性软组织破溃导致的并发症发生率为50%。每处损伤的伤口感染率为12.5%，闭合性（11.4%）和开放性（17.6%）治疗之间无显著差异。足踝部割草机损伤在充分冲洗和清创后可一期闭合，不影响感染率或功能。推荐使用抗生素预防。这些损伤中有六分之一涉及5岁以下儿童，且可预防。
