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Upper Extremity Friction Burns in the Pediatric Patient

A 10-year Review

Marchalik, Rachel, BA; Rada, Erin M., MD; Albino, Frank P., MD; Sauerhammer, Tina M., MD; Boyajian, Michael J., MD; Rogers, Gary F., MD, JD, MBA, MPH; Oh, Albert K., MD

Plastic and Reconstructive Surgery – Global Open: December 4, 2018 - Volume Latest Articles - Issue - p
doi: 10.1097/GOX.0000000000002048
Latest Articles: PDF Only

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.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

From the Division of Plastic Surgery, Children’s National Medical Center, Washington, D.C.

Published online 4 December 2018.

Received for publication April 27, 2018; accepted October 9, 2018.

Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors.

Albert K. Oh, MD, Division of Plastic and Reconstructive Surgery, Children’s National Medical Center, 111 Michigan Ave NW, 4th floor West Wing, Washington, DC 20010, Email:

Copyright © 2018 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved.