Multiple trauma in children patterns of injury--treatment strategy--outcome.
OBJECTIVE
In 1994 more than 50,000 children under 15 years were involved in a road accident in Germany. About one third of them received major injuries and 431 children died. These data obviously show the importance of multiple trauma in children in a developed country.


METHODS
Between 1985 and 1990, 64 multi-traumatized children were evaluated after receiving treatment at the Aachen University Hospital. It was possible to evaluate 66% of the patients at the follow-up examination after 1 and 5 years. The results have been measured with the ALOS (Aachen long-term outcome score) and the GOS (Glasgow outcome score) in relation to the degree of trauma. OWN RESULTS: 12.5% died mainly from the effects of a cerebral injury. 25% developed different complications. Again the effects of craniocerebral trauma determined the long-term outcome. All other injuries can be managed by aggressive treatment without major consequences.


CONCLUSIONS
In multi-traumatized children, craniocerebral trauma is the key injury regarding both lethality and long-term outcome. Therefore, prevention is of primary importance. Aggressive treatment of thoracic and abdominal trauma can usually help to cure completely these injuries. Especially osteosynthetic procedures, exerting little strain and performed as appropriate for children, have made injuries of the limbs less critical.
Magin
M N
MN
Department of Trauma Surgery, University Hospital, Rhenish-Westfalian Technical University, Aachen, Germany.
Erli
H J
HJ
Mehlhase
K
K
Paar
O
O
D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome