Snow blowers have certainly made our lives easier during the winter months. However, they are a potentially dangerous piece of machinery.
According to the US Consumer Safety Commission, as many as 5,300 hospital and emergency room visits each year are secondary to snow blower injuries. Since 1992 at least 19 deaths have occurred. Two deaths were secondary to people being caught in the machine and 5 were secondary to carbon monoxide poisoning when the snow blower was left running in an enclosed space.
According to the American Society for Surgery of the Hand, injuries most commonly occur in men in their mid 40′s. Two-thirds of injuries involve the fingers. The dominant hand is involved in 90 % of accidents, with the long finger most frequently amputated. Of the 5,300 injuries sustained over the study period, 1000 involved some degree of digital amputation.
Accidents tend to occur in first time users of snow blowers or during the first use of a given winter. Weather conditions play a part as well. Heavy, wet snow can clog machines. More accidents occur with snow falls greater than 6 inches.
Unfortunately nearly all lawnmower accidents are the result of human (operator) error. The two most common reasons people give us when performing a detailed history of the injury is either “I was in a hurry” or “I forgot.” Occasionally we see individuals who failed to read the operator manual and take appropriate action to prevent an injury, especially when performing repairs or maintenance on the device. It is clear that recognizing potential hazards before they occur is paramount to preventing injury. A fraction of a second and loss of concentration is all that is required.
From our experience most snow blower injuries are caused from heavy wet snow clogging the discharge chute of the snow blower. The operators’ attempt to clear the chute with their hands leads to severe injury. The individual may believe the machine is off though the blades may still be moving. The blades may also forcefully swing around after the snow is cleared. Injuries can also occur when using an appropriate technique to clear the snow with a broom handle or small shovel if the snow blower is not completely turned off prior to unclogging. The handle is swung around causing a severe crush injury and multiple hand fractures. Finally, burns can also occur from touching a extremely hot motor and projectiles can also cause serious eye injuries.
In our practice we’ve seen a higher percentage of partial amputations requiring a revision amputation of the digit or the need for multiple staged reconstructive procedures as we described in the article “Management of Traumatic Digital Fingertip Amputations” (Volume 1, Issue 1).
Patterns of injury which are typically seen occur from direct contact with jammed or rotating blades. Avulsion injuries are those in which soft tissue is torn and separated including bones. Gross contamination can occur from contact with, leaves, grass and pathogens harbored in the soil. All of these injuries require wound closure or reconstruction accompanied by appropriate debridement and antibiotic prophylaxis to reduce the risk of infection. Debridement may increase the amount of necessary tissue loss and lead to a more complicated reconstruction
The patient should be evaluated by a hand surgeon to see what reconstructive options are available. Skin defects can be treated with either skin grafts or flap coverage. Lacerated tendons and nerves can be repaired. Fractures can be treated as well, usually with k wire fixation. Unfortunately, in some cases due to the crushing mechanism, amputation may be the only option. Again, evaluation and management is best done by a hand surgeon who is familiar with the many reconstructive options.
Several Safety tips have been recommended by the ASSH to Prevent Hand Injuries:
- Always read instructions if unfamiliar with the machine.
- Never operate any machine intoxicated as concentration is needed.
- Never let children operate machinery.
- If the machine is jammed, turn it off first even if you think it is off.
- Always disengage the clutch. Always wait 5 or more seconds for the blade to stop.
- Beware of brief recall of motor and blades even after the machine is turned off.
- Take your time: the machine is more likely to jam if the job is rushed.
- Always use a large stick or broom to unclog the snow blower.
- Always keep hands and feet away from moving parts.
- Never disable the safety mechanisms.
Additional Recommendations include:
- Always wear slip resistant footwear to prevent slipping.
- Always wear protective eye shields to minimize projectile injuries.
- Always make sure the snow is directed to a space free of people, children and pets.
- Always know where the cord is at all times.
- Never leave the snow blower running in an enclosed area as carbon monoxide accumulates.
While no recommendations can eliminate all injuries, if one follows the above guidelines the risk of severe injury can be greatly reduced.
Have a fun and safe winter season!!
Information provided by: Hand & Plastic Surgery Associates, Ltd. – The physicians of HPSA treat the most challenging and complicated hand and wrist problems as well as minor conditions and injuries. They believe that seeing a physician who specializes in surgery of the hand yields the best results. When caring for injured workers, HPSA takes a proactive role to insure that these individuals are returned to work as soon as medically possible. They assist employers and case managers in determining appropriate job placement. Their physicians are also available for independent medical evaluations and second opinions. Visit their website at www.handplastic.com to learn more about HPSA.
