Young Kids and Lawn Mowers Don’t Mix

Amputation for OBuzzUntil I completed my pediatric orthopaedics rotation as a resident, I never thought much about pediatric lawn-mower injuries. I don’t recall how many such accidents we cared for during that time period, but I clearly remember one. It was grotesque and life-changing for the child–and definitely avoidable. That recollection was reinforced while I read the epidemiological study by Fletcher et al. in the October 17, 2018 edition of The Journal.

The authors analyzed 20 years of data from their institution in an effort to better understand these horrific injuries. They found two main demographic populations among the 157 patients who sustained mower-related injuries, which were lower-extremity injuries in 84% of all the patients. Those in the younger at-risk population (mean age of 4 years) were frequently injured by (or were passengers on) a riding lawn mower, usually operated by an older family member. This younger cohort had higher injury severity scores and higher amputation rates than the older pediatric population of mower-injured patients (mean age of 15 years). Most of those older patients were hurt while operating the lawn mower themselves.  Not surprisingly, the authors found that these patients, whatever their age, underwent an average of almost three operations and spent close to a week in the hospital.

While there are a lot of important epidemiological data points in this article, the most important take-home message is the role that education must play in the prevention of these injuries.  As the author state:

Education for the younger population should target the operators (parents, grandparents, older siblings) and emphasize the importance of keeping children out of the yard while lawn mowers are in use. Under no circumstance should a child of any age be the passenger on a lawn mower.

Despite ample literature on lawn-mower injuries, their incidence among pediatric patients has remained largely unchanged. I’m hopeful that this study will prompt more widespread implementation of patient education in this area. The American Academy of Orthopaedic Surgeons has information regarding lawn mower safety, and the Pediatric Orthopaedic Society of North America and the American Academy of Pediatrics are partnering on lawn-mower injury prevention. Accidents cannot be eradicated completely,  but the more we avail ourselves of resources such as these—and  share them with patients of all ages—the greater the likelihood of preventing these potentially devastating injuries.

Chad A. Krueger, MD
JBJS Deputy Editor for Social Media

One thought on “Young Kids and Lawn Mowers Don’t Mix

  1. It may have been a generational mismatch in perception, a geographical quirk, or even a socioeconomic association, but I am very curious to find that the authors did not appear to differentiate motorised push lawn mowers versus the hand push version some of us may have been more familiar with from previous generation, lower socioeconomic areas, or simply from different continents.

    The significance is real as the expectations of a hand-pushed lawn mower may involve a different set of injuries, particularly when the sharp grass-cutting rotary edges are less likely to be moving if the mower is stationary.

    Perhaps in the age of easy access to affordable motorised mowers, with the increasingly common trend to pay children to mow the lawn, it is no surprise that serious lawn mower injuries are on the rise.

    Here “down under,” while motorised lawn mower injuries contribute significantly to injuries in both adults and children, my concerns are more on the increasing popularity and normalisation of Quad Bikes [four-wheeled all-terrain vehicles] for use by children, which is relatively unregulated.

    The presentations of paediatric poly-trauma from quad-bike related accidents are rising in numbers and severity, and there are calls for a ban in certain parts of the community (

    Unfortunately, these voices are still in the minority and remain out of consciousness among the general public.

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