Charles T Price, Michael J. Muszynski, Julie A Zielinski and Charles Stewart
Background: Motorboat propeller strikes can cause devastating injury due to injury mechanics and complex contamination. The frequency of these injuries has been under-reported. This paper provides a review of propeller injuries admitted to our hospital over a six-year period. Discussion includes injury mechanics, initial management, literature review, accident statistics, and possible prevention measures.
Methods: Charts of all patients admitted to our hospital following boating injury were reviewed. Thirteen patients were identified with motorboat propeller injuries. A review of boating accident statistics during the same period of time was also conducted.
Results: Patients averaged 2.8 surgical procedures during the initial hospitalization. Infections developed in 46% of patients and there were five amputations in three patients. During the period of this study the number of reported propeller or skeg boating accidents increased from 8 per year to 80 per year in Florida.
Conclusions: Motorboat propeller injuries can be extensive due to severe mechanical damage and contamination with uncommon marine organisms. Blood loss and contamination may be underestimated at time of admission. Therapeutic triple antibiotic management and frequent irrigation and debridement are recommended. Multiple surgical procedures and extended hospitalization are often required with lifelong physical impairment as the final outcome. The apparent increase in reported injuries probably reflects improved accuracy of reporting rather than true increase in frequency of these injuries. Safety education and enforcement along with development and implementation of safety devices is recommended.
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