Upper Extremity Friction Burns in the Pediatric Patient: A 10-year Review

Abstract

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.

Treadmill Hand Injuries Among Children: A Retrospective Case Series From Hospitalized Patients

“…The numbers of male and female patients in this study were roughly equal. Children younger than 4 years old accounted for the great majority (78.3%), which was basically consistent with previous studies ( 4 , 5 ). Children of this age have significantly high exposure to the outside world after learning to walk and run, while their insufficient awareness of the dangers ultimately leads to the injury.…”

A Next-Generation Friction Burn Caused by a Cordless Vacuum Cleaner

“…Friction burns caused by home exercise equipment, such as treadmills, have been widely reported for decades. In contrast, research on vacuum cleaner-related friction burns has been insufficient [3], and the severity of these wounds may therefore be underestimated on initial evaluation. In particular, a recently developed type of digital motorpowered vacuum cleaner with a soft roller head is increasingly replacing traditional vacuum cleaners, which emphasized the power of suction itself.…”

“…Only a few years ago, vacuum cleaner-related friction burns were thought to be less severe than those caused by the firm rubberized belt of a treadmill, as the motors that rotated the nylon bristles on a vacuum cleaner's brush cylinder were less powerful than those used in treadmills [3,6,7]. However, conservative treatment may not be sufficient for burns caused by strong friction with the antistatic fine carbon-fiber filament on the soft roller heads in the more recent vacuum cleaner models.…”

“…As more people exercise at home with fitness equipment, there have been more reports of treadmill-related burn injuries in children [2]. Most are deep partial-thickness or full-thickness burns, requiring a surgical approach such as debridement or skin grafting [3]. As a result of the abundance of reports on treadmill-related friction burns, appropriate treatment protocols are well established, whereas fewer cases have been reported on friction burns caused by vacuum cleaners, considered to be of less importance or severity [3].…”

Perioral petechiae and pulmonary haemorrhage, thinking outside the vacuum

“…It revealed four relevant articles reporting 13 cases of vacuum cleaner inflicted hand burns in children and 2 auto-stimulation penile injuries in adolescents. [1][2][3][4] There were no acute lung injuries reported.…”