Five-year-old Joel McLean shows RCH plastic surgeon Associate Professor Bruce Johnstone how lucky he is to have the use of his left arm, after it was nearly severed in a ride-on lawn mower injury.
Surgeons at The Royal Children’s Hospital (RCH) have called for behavioural change and stricter consumer controls to protect children from potentially horrific injuries as a result of ride-on lawn mower misuse.
RCH plastic surgeon Associate Professor Bruce Johnstone said the campaign was a response to a gradual increase in the number of children being critically hurt by ride-on mowers, and fears that injuries would continue to escalate as the machines became a more common and affordable consumer item.
“In the last 12 months we’ve operated on five children who’ve been critically injured after falling from, or falling behind a ride-on mower,” A/Professor Johnstone said.
“These are horrific injuries, often requiring amputations of limbs and extensive skin grafts, and the victims are typically boys aged about four-years who face ongoing surgery and problems into early adulthood.
“People must remember that ride-on mowers are not recreational vehicles and should never be considered a ‘ride’ for children. Ride-on mowers are dangerous pieces of equipment and the blades can cause considerable, life-altering injury.
“We want parents and families to treat any area in which one of these machines is being used as a no-go zone for their kids.”
A/Professor Johnstone and a team from the RCH is also liaising with industry, the ACCC and other regulatory bodies to see if there is room to strengthen consumer controls and standards on ride-on lawn mowers.
A 30-year review of ride-on lawn mower injuries at the RCH published in 2008 confirmed injuries from ride-on mower use were steadily increasing. Surgeons are predicting a further increase to 15 injuries over the next five years – double the injury rate of 1990–1999.
The common scenarios for ride-on mower injury include:
• Small children, commonly four-year-old boys, reversed over by the mower when out of the driver’s line of sight
• Children injured by a sibling, who was driving the mower recreationally
• Children slipping off the lap of a parent, who was driving the mower.
Joel McLean, 4 at the time, was flown to the RCH on 26 June last year after being reversed over by a ride-on mower driven by his father on the family’s seven-acre property. The accident occurred in seconds, and left Joel’s forearm almost completely severed.
Joel required three major operations lasting a total of 14 hours during his first admission over 11 days. The first focused on cleaning the extremely contaminated wounds, removing unsalvageable and dead tissues and pinning his forearm bones. Many important structures including the middle 1/3 of the ulnar bone were missing.
The most complex reconstructive procedure occurred on day four and took nine hours. A large area of muscle and skin was transplanted from his back to fill the massive forearm defect and brought in vascularised nerve. This, plus other nerve grafts, were used to reconstruct the ulnar nerve, which is essential for fine hand function. A month later a rib graft was used to bridge the defect in the ulnar bone.
A/Professor Johnstone said all of these procedures had been remarkably successful; however, due to the violence of the injury, poor blood supply to the centres of the bones prevented healing of fractures. A further bone plating operation occurred in August of this year.
Joel’s father, Daniel McLean, recalled the circumstances that led to the horrible incident.
“As I was mowing up and down the slope I came back and I felt a big bump, and it wasn’t until I looked down that I noticed Joel was under the mower,” Daniel said.
“I shut the mower down straight away. You hear of getting the strength of ten men and you do. I had to pull the mower off and pull him out. There was a lot of blood. It was a very traumatic experience. My other boy Keith saw the whole thing.”
“It was one of those things, I had mowed the lawn hundreds of times and I thought the boys were inside,” he said.
Joel’s mother Tammy McLean remembers the incident all too well, and says she and husband Daniel worked quickly to take Joel to hospital.
“I heard Daniel yelling and ran around the corner of the house to see him holding Joel’s arm together,” Tammy said.
“As there was too much blood, we knew we couldn’t wait for an ambulance and drove straight to Albury Base Hospital.
“I did not think he would still have an arm, but hoped he would still have a leg,” she said.
Joel has had at least six operations at the RCH to repair his arm and continues to have regular physiotherapy, hand therapy and hydrotherapy, either at the RCH or with local health providers.
A/Professor Johnstone attributes the increase in injuries to a number of factors, including a rise in the number of ‘hobby’ farms utilising ride-on mowers and the increasing affordability of ride-on mowers. He also says the behaviour of retail staff at the point of sale of these machines is a concern.
“I’ve heard stories of ride-on mower retailers demonstrating to customers how to disengage safety mechanisms that cause the blades to stop turning when the mower is in reverse,” he said.
Despite these trends, the message is clear.
“If I had to draft legislation, I’d say: ‘Keep children under the age of 10 out of the same paddock or area as a ride-on mower’,” A/Professor Johnstone said.
Tammy McLean says it will be a culture change for some families.
“I grew up on a farm and we’d ride tractors and other machines all the time. We think our children know that mowers are dangerous and not to go near them. Make sure children are inside – kids and mowers don’t mix,” Tammy said.