Chest Traumas Due To Bicycle Accident in Childhood

Abstract

Aim Childhood injuries are the leading cause of death in children and result in significant healthcare utilization. Trauma is the second most common cause of mortality in children aged 1-4 years and leading cause of death in children older than 4 years. Thoracic injury is the second most leading cause of death in traumatized children. Multisystemic injury is found in more than 50% of children with thoracic injuries most of which are secondary to blunt traumas. We planned this study to evaluate thorax trauma cases secondary to bicycle driving in childhood and to draw attention to the importance of the regulation of traffic rules, the education of bicycle drivers. Material and Methods A retrospective evaluation was performed in 17 pediatric patients admitted to the Department of Thoracic Surgery during 2006-2010 with a diagnosis of chest trauma due to bicycle driving. For every patient, a pediatric trauma score (PTS) was calculated. Descriptive statistics were performed for PTS. Results Eleven (64.70%) cases were injured due to the tricycle accidents and six cases 6 (35.29%) were injured due to the two-wheeled bicycle accidents. The most frequent thoracic pathologies included pulmonary contusion (41.2%) and chest wall contusion (29.41%). Extrathoracic injuries were seen in 35.29%, the extremities (17.64%) and abdomino pelvic (11.76%) being the most commonly involved. Treatment consisted of symptomatic treatment in 12 patients (70.58%), tube thoracostomy in 2 patients (11.76%), and thoracotomy in 1 patient (5.9%). The morbidity was seen in 3 patients (17.64%). The mortality rate was 5.9% (n:1). The mean PTS of the cases who had additional system injuries were significantly worse than the cases who had isolated chest traumas. Conclusions The pediatric thorax has a greater cartilage content and incomplete ossification of the ribs. Due to the pliability of the pediatric rib cage and mediastinal mobility, significant intrathoracic injury may exist in the absence of external signs of trauma. Pulmonary contusion and pneumothorax are frequently present without rib fractures. Pulmonary contusion, pneumothorax, and rib fractures are the most common injuries. In order to prevent bicycle accidents; bicycle drivers should have specific education, helmet use must become widespread and special traffic regulations have to be settled. Increasing the education level if family will contribute to the prevention of childhood trauma.