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Upper Extremity Friction Burns in the Pediatric Patient: A 10-year Review
Rachel Marchalik1, Erin M Rada1, Frank P Albino1
1Division of Plastic Surgery, Children's National Medical Center, Washington, D.C.
Insights
Pediatric friction burns from treadmills often require surgery, while vacuum cleaner burns heal well with conservative care. This highlights differing injury patterns and treatment needs for common household equipment accidents in children.
Area of Science:
- Pediatric medicine
- Burn injuries
- Trauma surgery
Background:
- Upper extremity friction burns in children are an increasing concern.
- Powered home equipment is a common cause of these injuries.
- Understanding the specific mechanisms and outcomes is crucial for pediatric care.
Purpose of the Study:
- To review the causes, presentation, characteristics, and treatment of pediatric upper extremity friction burns.
- To differentiate between injuries caused by treadmills and vacuum cleaners.
- To analyze the need for surgical intervention and functional recovery based on the injury source.
Main Methods:
- Retrospective chart review of pediatric patients treated between 2003 and 2012.
- Identification of patients using International Classification of Diseases, version 9 (ICD-9) codes.
- Analysis of injury mechanisms, treatment, and patient outcomes.
Main Results:
- Sixty-nine pediatric patients with upper extremity friction burns were identified.
- Treadmills caused 63 injuries, while vacuum cleaners caused 6.
- Treadmill burns more frequently required surgery (30% of patients) and resulted in poorer functional recovery compared to vacuum cleaner burns, which were treated conservatively with excellent outcomes.
Conclusions:
- Friction burns from vacuum cleaners in children are less common, present differently, and are effectively managed with conservative treatment.
- Treadmill-induced friction burns lead to more severe injuries, often necessitating surgical intervention and carrying a higher risk of long-term functional impairment.
Background:
Upper extremity friction burn due to powered home equipment is a growing problem in the pediatric population. The purpose of this study was to review the etiology, presentation, characteristics, and treatment of this particular type of pediatric mechanism of injury.
Methods:
A retrospective chart review using International Classification of Diseases, version 9, codes for patients treated at a large tertiary care, free-standing children's hospital was performed to identify all patients presenting with an upper extremity friction burn from 2003 to 2012.
Results:
Sixty-nine patients sustained upper extremity friction burns. The average age at the time of injury was 3.3 years (range, 0.7-10.6) with presentation to our center occurring 16.6 days (range, 0-365 days) following injury. Mean follow-up was 23.3 months (range, 2-104). Mechanism of injury included treadmills (n = 63) and vacuum cleaners (n = 6). Twenty-eight operations were performed on 21 patients (30%). All patients requiring a surgical intervention sustained injury via treadmill mechanism (P = 0.0001). Unlike treadmill burns, vacuum cleaner injuries affected the dorsal hand or a single digit (P = 0.00004). Scar hyperpigmentation was more prevalent in these patients compared with the treadmill group (P = 0.003). All vacuum-induced burn patients had full range of motion and function with conservative treatment alone, whereas only 55.6% of treadmill burn patients had full recovery of range of motion and 50.8% recovery of full hand function.
Conclusions:
Friction burns from vacuum cleaners are less prevalent, have different injury patterns, and can be treated conservatively with excellent functional outcomes. Treadmill friction burns result in more significant injury and risk for dysfunction, requiring surgical intervention.
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