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American Association for Hand Surgery

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Snowblower Hand Injuries, Mechanisms, and Disability: a Longitudinal Study
Patrick Bryan Curtin, MD1, Matthew Defazio, MD1, Kathryn Hiller, BA1, Forrest Rackard, MD1, Marci Jones, MD2 and Eric Swart, MD1, (1)University of Massachusetts, Worcester, MA, (2)Department of Orthopedics, University of Massachusetts, Worcester, MA

Introduction:
Snow blowers have long been recognized in the hand community as a danger. Despite this observation, many companies do not recognize them as a significant risk and only recently, February of 2021, has there been a recall due to amputation risk on specific models. Literature around snow blower injuries is also limited, with the few existing small cohort studies largely focusing on incidence or mechanism basics, and lack information on injury treatment or outcomes. The aim of our study is to better understand the types of injuries patients experience from snow blowers, their treatment, and long-term outcomes.

Materials & Methods:
Snow blower injuries at a level-one trauma center in an area that receives substantial snowfall were identified over a 10-year period. For these patients, mechanism, injuries, treatment, and follow-up were recorded from the electronic medical record. All patients were also called to confirm injury details, and assess function (QuickDASH survey).

Results:
52 patients were identified, with 49 (92%) males, and an average age of 50.3 years. The most common mechanism of injury was attempting to unclog snow blower by reaching hand into machine (83%), followed by clothing or gloves getting caught in the machine (14%). Hand dominance did not correlate with side of injured upper extremity.

All patients had significant soft tissue injuries and at least one fractured digit. 65% had 2 or more fractured digits, and 52% had amputation of at least one digit. The most commonly injured digit was the long finger, with the thumb least likely to be injured. 22 patients (43%) required surgery for revision amputation or fracture fixation, with 18% requiring reoperation.

Of the 52 patients, 8 were able to be reached for interview. All still reported mild to severe limitations, with 2 patients scoring in the poor category (QuickDASH > 35). The most common limitations were moderate to severe tingling (88%) or pain (63%) of injured extremity. All patients interviewed were injured attempting to clear snow from the chute while the machine was on.

Conclusions:
Current snow blower models allow for dangerous access to the rotating components, making unclogging of machine or accidental snagging of extremities a significant health risk. Snow blower injuries in our cohort were always severe, with all patients suffering from significant soft tissue injury and fracture, and over half with amputation of at least one digit. Further studies are needed to further characterize the degree of disability after injury.


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