Articles Tagged with amputation of limb

Dune buggy accidents are not an everyday occurrence primarily because few people ride them. However, among those that do, accidents are fairly common.

The dune buggy usually travels at a great speed over rough terrain. Therefore, rollovers or loss of control of the vehicle are common events that lead to serious injuries, including amputations.Research indicates that the dune buggy can cause severe injuries requiring the amputation of upper extremities, hands, lower extremities or feet.

Below are recent headlines from U.S. newspapers that highlight the severe injuries that can occur with the use of this type of vehicle.

In 2012, a young couple was killed while at a Cozumel vacation spot touring the area. There were five people on the large dune buggy when it slammed into a metal guardrail, killing the couple. The other riders and the driver, who lost control of the vehicle, were only slightly injured.

Allowing minors to operate a dune buggy has often resulted in tragedy. Another dune buggy injury happened to a girl that was only 11 years old at the time of the accident. After losing control of the vehicle, the young lady fell off. She sustained two broken knees and a broken thumb. Additionally, she had deep gashes in her forehead and body due to the glass breaking on the vehicle. She was airlifted to Yuma, Arizona, where she underwent surgery to both knees and had a thigh high cast for 6 weeks. She was told that she would never walk again. Because she was a soccer player, she was obviously devastated. She underwent physical therapy and rehab for two months. Fortunately, the young lady was able to recover a great deal of her mobility in her lower extremities.

Unfortunately, the girl’s story is not uncommon. Worse, many victims die or are seriously maimed by this type of accident. In this case, the cost of the medical attention and rehabilitation she received was high. The cost of such bills presents a problem to many victims as not every person has the insurance coverage to pay for such treatment.

Not all dune buggy accidents are single vehicle accidents and this is one example. A young driver of a dune buggy was killed in Nevada. The dune buggy driver, only 19 years of age, was driving on a dirt road when he lost control of his vehicle and slid into the path of an oncoming truck. Reports indicate that the dune buggy was moving at a high speed rate. The impact was severe. Sadly, the young man was pronounced dead at the scene. His passenger was seriously injured and was taken to a Reno Hospital for further evaluation and management. The people in the truck were relatively uninjured.

Some dune buggy injuries are relatively unusual and typical only of dune buggy accidents. An example of an injury specific to this type of recreational vehicle typically occurs to the hand. In most cases it is of the passenger who will instinctively grab the roll bar during a rollover. This results in a crush injury with amputation or avulsion at the level of the metacarpals. The thumb is usually spared but the rest of the fingers are either lost or partially lost. Because of the locale of these rollover accidents, the wounds are often seriously contaminated and there is often a delay of appropriate treatment.

One article indicated that there should be a redesign of the roll bar and better protection of the passenger so that the passenger can’t reach up, grab the roll bar and crush his or her fingers. The U.S. Product Safety Commission has published reminders to help keep the above mentioned type of injuries from occurring.

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Among children, 60 percent of amputations are congenital in nature and 40 percent are acquired due to an injury. Most of these patients require some kind of prosthetic device more so than children who’ve sustained congenital amputations. These acquired amputee children attend specialized child amputee clinics. Acquired amputees are due to trauma most of the time but in a few cases, the limb loss was secondary to disease. The worst offenders are power tools and heavy machinery, followed by automobile accidents, explosions, gunshot wounds and railroad accidents. In the 1-4 age groups, the most common causes of amputation are lawnmowers and household accidents.

Of diseases causing amputation, the most common cause is malignancies, vascular malformations and neurogenic disorders. More than 90 percent of the time, acquired amputations involve just one extremity. In over 60 percent of the cases, the lower limb is the limb affected. Males have more amputations than females at a ratio of 3:2. This is because males tend to engage in activities that are more hazardous than females.

Water sports are becoming more popular around the world. People are spending more time racing boats, water skiing, scuba diving and skin diving. Injuries because of boat propellers are also becoming more frequent. One study looked at the ten year period from 1963-1973 and studied nine cases of injury by boat propeller. Some resulted in an amputation as a result of the propeller itself. Others needed surgical amputation due to mangled extremities.

Injuries on boats are not simply a national occurrence. The below examples are listed not for shock value but to illustrate the need to use caution when on or near boats. These were recent news items from 2012 and 2013 illustrating the mechanism of injury due to water sports and/or while on a watercraft.

Children have a higher likelihood of being injured or killed from trains than adults. They like to play on train tracks and have a lesser ability to detect the speed of a train coming towards them. Their bodies are more frail than adult bodies and the forces on the bodies from the train are great.

One study looked at the pattern of sustained injuries in kids who are injured in train tracks and train accidents. It was a retrospective review of those patients who showed up on two different trauma registries for the years 1984 through 1994. The patients attended a level I trauma center in a single metropolitan area. A total of 17 patients were treated for injuries at the level I trauma center. Those who were injured in a car that was struck by a train and those that were pronounced deceased at the scene were excluded from the study.

Fingertip accidents are commonplace amputations at home or on the job. Fingertips can slam in doors, in car doors, while chopping food or when clearing out a lawnmower or snowblower. These types of injuries can involve crushing of the fingertip, tearing of the fingertip or cutting off of the fingertip, including the thumb. The nailbed, soft tissue and bone (phalanx) can be involved in the injury. The tips of the fingers are injured more commonly than the rest of the finger because they are the least likely to escape harm’s way.

These types of amputations are very painful because there are a lot of nerves in the area. They also tend to bleed quite a lot due to a rich blood supply. When an amputation happens, you should elevate the stump and cover the wound with a sterile dry dressing. Apply pressure if needed. If there is a part of the finger that is cut off, it should be wrapped in a moist sterile gauze and placed in a baggie. You should then place the baggie in some ice water. Don’t put the amputated part directly on ice and do not use dry ice to keep the amputated part cold.

Finger amputations may sound small but they really cause a lot of changes in the way the patient performs certain activities, such as punching the buttons on a phone or using a keyboard. This is why the surgeon will attempt to put the finger back on if it is severed from the hand.

When a finger is initially severed, the bystander should wrap the amputated finger in moist, cool gauze. The finger should not be immersed in water because it can become waterlogged. Simply use a paper towel if you have no medical gauze. Put the finger on ice with a Ziploc bag. Do not use dry ice for this part of the process. If there will be an attempt to reimplant the finger, there should be immediate medical attention with a surgeon who can put arteries, veins and nerves back together. The time from amputation to reimplantation should be less than 12 hours.

Subway accidents can have devastating consequences to those involved. In fact, many people do not survive pedestrian versus subway collisions. While, the subway system is designed with the intent to be safe they are not immune to issues. When things do go wrong, people suffer from serious permanent injury and death.

In one study a retrospective review occurred using information between the years of 1989 and 2003. In the study, they found 41 patients who were involved in a subway accident and that had presented to Bellevue Hospital in New York City for treatment. The researchers collected pertinent information such as the patient age, gender, the Injury Severity Score, the time of the accident, and the mechanism by which the accident happened.

Above the elbow amputations are also called trans-humeral amputations and are more difficult than below the elbow amputations to fit with prostheses that are comfortable and functional. When the injury happens at the level of the elbow or above, the person must have a transhumeral amputation with the attempt made to have the stump as long as possible. Longer stumps can help the individual use the prosthesis more effectively.

Another above the elbow amputation that is more severe is through the shoulder with shoulder disarticulation. These are the hardest to place with a prosthesis that the patient can easily use and tend to be unwieldy and more for aesthetics than for functionality. The more joints that have to be replaced, the harder it is to have a functional prosthetic.