Voth M, Lustenberger T, Auner B, Frank J, Marzi I
Department of Trauma, Hand and Reconstructive Surgery, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany.
Injury. 2017 Oct;48(10):2119-2124. doi: 10.1016/j.injury.2017.07.027. Epub 2017 Jul 27.
Beside serious and potentially fatal injuries, the majority of pediatric trauma patients present with minor injuries to emergency departments. The aim of this study was to evaluate age-related injury pattern, trauma mechanism as well as the need for surgery in pediatric patients.
Retrospective Study from 01/2008 to 12/2012 at a level I trauma center. All patients <18years of age following trauma were included. Injury mechanism, injury pattern as well as need for surgery were analyzed according to different age groups (0-3 years, 4-7 years, 8-12 years and 13-17 years). Major injuries were defined as fractures, dislocations and visceral organ injuries. Minor injuries included contusions and superficial wounds.
Overall, 15300 patients were included (59% male, median age 8 years). A total of 303 patients (2%) were admitted to the resuscitation room and of these, 69 (0.5% of all patients) were multiply injured (median Injury Severity Score (ISS) 20 pts). Major injuries were found in 3953 patients (26%). Minor injuries were documented in 11347 patients (74%). Of those patients with a major injury, 76% (2991 patients) suffered a fracture, 3% (132 patients) a dislocation and 3% (131 patients) an injury of nerves, tendons or ligaments. The majority of fractures were located in the upper extremity (73%) (elbow fractures 16%; radius fractures 16%; finger fractures 14%). Patients with minor injuries presented with head injuries (34%), finger injuries (10%) and injuries of the upper ankle (9%). The most common trauma mechanisms included impact (41%), followed by falls from standing height (24%), sport injuries (15%) and traffic accidents (9%). Overall, 1558 patients (10%) were operated. Of these, 61% had a major and 39% a minor injury.
Almost 75% of all children, who presented to the emergency department following trauma revealed minor injuries. However, 25% suffered a relevant, major injury and 0.5% suffered a multiple trauma with a median ISS of 20. Overall, 10% had to be operated. The most frequently found major injuries were extremity fractures, with elbow fractures as the most common fracture.
除了严重的、可能致命的损伤外，大多数儿科创伤患者在急诊科表现为轻伤。本研究的目的是评估儿科患者与年龄相关的损伤模式、创伤机制以及手术需求。
对2008年1月至2012年12月在一级创伤中心进行的回顾性研究。纳入所有18岁以下创伤患者。根据不同年龄组（0 - 3岁、4 - 7岁、8 - 12岁和13 - 17岁）分析损伤机制、损伤模式以及手术需求。重伤定义为骨折、脱位和内脏器官损伤。轻伤包括挫伤和浅表伤口。
总体上，纳入15300例患者（男性占59%，中位年龄8岁）。共有303例患者（2%）被送入复苏室，其中69例（占所有患者的0.5%）为多发伤（中位损伤严重度评分（ISS）20分）。3953例患者（26%）有重伤。11347例患者（74%）有轻伤记录。在重伤患者中，76%（2991例患者）发生骨折，3%（132例患者）发生脱位，3%（131例患者）发生神经、肌腱或韧带损伤。大多数骨折位于上肢（73%）（肘部骨折16%；桡骨骨折16%；手指骨折14%）。轻伤患者表现为头部损伤（34%）、手指损伤（10%）和上踝关节损伤（9%）。最常见的创伤机制包括撞击（41%），其次是从站立高度跌落（24%）、运动损伤（15%）和交通事故（9%）。总体上，1558例患者（10%）接受了手术。其中，61%有重伤，39%有轻伤。
在创伤后到急诊科就诊的所有儿童中，近75%为轻伤。然而，25%遭受了相关的重伤，0.5%遭受了多发伤，中位ISS为20。总体而言，10%的患者需要接受手术。最常见的重伤是四肢骨折，肘部骨折是最常见的骨折类型。
