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

Abstract

Background: With the progress of modernization, treadmill hand injury in pediatric population is taking on a global trend in recent years. The purpose of this study was to investigate the epidemiology and clinical features in a developing country, thereby providing some experience in the treatment and prevention of this particular type of injury. Methods: A 5-year retrospective review of patients with treadmill hand injury in Burn and Plastic Surgery ward at Children' Hospital of Chongqing Medical University was conducted. Demographics, injury details, therapy performed, length of hospital stay, complications, and outcome were analyzed. Results: Forty-six patients were surveyed, with a mean age of 3.5 ± 2.0 years old, including 24 males and 22 females. Injuries (77.8%) occurred between dinner to bedtime, and 95.7% happened indoors. Fingers were the most vulnerable part, of which the middle finger, ring finger, and index finger were the top three ones. The mean body surface area (BSA%) was 0.3 ± 0.2, but at least in deep dermal. Dressing changes, full-thickness skin grafts (FTSG), and Negative Pleasure Wound Therapy (NPWT) assisted FTSG were performed. The scar contracture, as the most severe complication, occurred in 26 patients, of which 22 originally received dressing changes at the time of injury. Conclusion: Treadmill hand injury in children should be highly regarded. Compared with conservative dressing changes, surgical intervention from a professional team may achieve more satisfactory prognosis and fewer complications. A prevention strategy based on "Time-Space-Person" was summarized according to its epidemiological characteristics, may help to decrease the incidence of this specific type of injury theoretically.

Keywords: epidemiology; hand injury; pediatric/child; treadmill; treatment.

Figure 1

Injury patterns of the involved 116 fingers. The inner circle of the pie chart represents the number of involved fingers in each injured hand. The outer circle of the pie chart shows how these finger injuries are combined.

Figure 2

Treadmill hand injury in the index finger, middle finger, and ring finger of the right hand. The patient initially received 9 days of outpatient dressing changes in our center. The wound in index finger and small finger were almost healed. However, the wound in middle finger and ring finger were serious, presenting a poor healing.

Figure 3

Scar contracture in a rain finger and its corresponding management. (A) The scar contracture occurred in the proximal interphalangeal joint of the ring finger, with 45 degrees. (B) The Z-plasty scar release and FTSG, as well as the Kirschner wire internal fixation.

Figure 4

The time of injury in 27 patients according to the day of the week and the time of the day. The time of injury in “trauma group” and “early complication group” (27 patients) are depicted in this figure. A dot represented a patient. Blue, yellow, and red represent the injury that occurred before lunch, between lunch and dinner, and after dinner. Data in “scar contracture” group were not included because the first-hand data were unavailable, and their parents failed to recall the exact time of injury.