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Cuts

The sharp blades of a mower can injure the skin or go deeper into the muscles, ligaments, tendons, and bones. Cuts from lawn mowers can occur anywhere on the body but most often occur on the hands and feet, which can most easily get past the blade protectors. 

A child receiving treatment in the emergency room for a cut from a lawn mower.

Burns

The hot engine or gas tank of a lawn mower, or the exhaust from a gas-powered mower, can cause burns. Burns can happen anywhere on the body. They can damage the skin or go deeper into the tissues injuring muscles, ligaments, tendons, and bones.

Broken Bones (Fractures)

The sharp, rotating blades of a mower can cause broken bones.

Open fractures — in which the skin over a broken bone is cut or torn — are very common in lawn mower injuries. In addition to the broken bone, open fractures can cause serious injury to the surrounding muscles, tendons, and ligaments, and increase the likelihood of infection and other complications in the wound and the bone. As a result, the treatment and recovery time is greater for an open fracture than it is for a closed fracture in which the skin is not cut.

Amputation

In addition to causing cuts and tears, the sharp blades of a mower can sever part of an arm, leg, hand, or foot. Burns, cuts, and fractures can be so severe that the injured part of the body requires amputation to prevent infection and further complications. 

Wounds

• An open wound can be covered lightly with a clean, dry bandage or cloth.
• If there is bleeding, apply gentle, direct pressure to the wound.
• Raising the child's arm above the heart will help minimize bleeding.

Fracture

• If you think there might be a broken bone, it is best not to move the limb until help arrives or until you can make a splint to hold the bone. 
• If a broken bone is sticking out of the skin (open fracture), do not push the bone back in.

Amputation

• If there has been an amputation, the separated body part should be brought to the hospital with you. In some cases the doctor may be able to reattach it.
• Wrap the amputated part in a clean, damp bandage, and seal it in a plastic bag. Put the plastic bag in a container of water mixed with some ice. Be careful not to freeze the part — just keep it very cool.

Cuts

• Mild cuts may only need cleaning and bandaging.
• More serious cuts that are deeper or involve muscles, tendons, or ligaments may require cleaning. This involves using saline or another solution to wash out debris and bacteria to prevent infection. This procedure can take place in either the emergency department or operating room.
• Depending on how much skin and tissue is lost, a cut may require surgery to ensure healing. During surgery, torn structures can be repaired and, sometimes, a piece of skin (skin graft) may be taken from another area of the body and used to cover the injury.

Burns

• Severe burns may require surgery and treatment from a burn surgeon.
• If a wound is contaminated with grass, clothing, or other material, it may require more than one operation to avoid infection and ensure that the wound is clean enough to heal. 

Fractures

Broken bones can sometimes be treated with just a cast or splint. If the bones are in a poor position and do not line up properly to heal, the doctor may have to move or realign them before placing a cast or splint over the injured area.

Open fractures

• If the skin is open over a broken bone and the bone is exposed, the injury needs to be cleaned and irrigated before surgery to fix the fracture.
• During surgery, the broken bones are put back into place and then fixed using devices like wires, screws, plates, or rods. This type of procedure is called internal fixation.
• Sometimes an external fixator is used to secure the bones when damage to the skin and soft tissues prohibits an internal fixation. An external fixator is a metal frame that holds the broken bones in place with small pins that go through the skin and into the bone above and below the break. 

(Left) This child's open fracture has been treated with external fixation. (Right) There are different types of external fixators. Depending on the injury, a circular external fixator, like the one shown here, may be used.

(Right) Courtesy of Texas Scottish Rite Hospital for Children

Growth plate fractures

When a child breaks a bone, there can be injury to the growth plate (physis). Growth plates are areas of developing cartilage tissue near the ends of long bones. These plates regulate and help determine the length and shape of mature bone.

When a growth plate is severely injured, it can slow or stop growth in the bone. This can cause differences in the length or the size of limbs. Damaged growth plates also can cause limbs to grow crooked. 

• Many growth plate fractures can be treated with cast immobilization, but surgical treatment may be necessary.
• Growth plate fractures require regular follow-up visits with your doctor to ensure proper long-term results. 

This fracture of the thighbone (femur) goes through the growth plate and down into the knee joint. The fracture is fixed in place with screws to restore normal joint alignment.

Amputation

• If part of a limb is amputated or nearly amputated, the surgeon will decide if the injured part can be reattached.
• If the body part has been detached for too long, or if the injury is too severe, reattachment may not be possible.

Severe Injuries

Severe injuries may require reconstructive surgery.

• In these procedures, the surgeon may need to shift healthy bones, muscles, tendons, or skin to new positions where they can compensate for body parts that are missing or working poorly.
• Depending on the type of injury, reconstructive procedures can be performed within days or weeks of the initial treatment, or it may be months before reconstructive surgery is recommended.

Reconstructive surgery can improve the way the body works and how it looks. It typically requires a team approach with orthopaedic surgeons working alongside plastic surgeons and vascular surgeons to ensure the best possible outcome.