title: Blunt chest trauma in childhood.
abstract: BACKGROUND
  Although thoracic injuries are uncommon in children, their rate of morbidity and mortality is high. The aim of this study was to evaluate the clinical features of children with blunt chest injury and to investigate the predictive accuracy of their paediatric trauma scores (PTS).
  
  
  METHODS
  Between September 1996 and September 2006, children with blunt thoracic trauma were evaluated retrospectively. Clinical features and PTS of the patients were recorded.
  
  
  RESULTS
  There were 27 male and 17 female patients. The mean age was 7.1 +/- 3.4 years, and the mean PTS was 7.6 +/- 2.4. Nineteen cases were injuries caused by motor vehicle/pedestrian accidents, 11 motor vehicle accidents, 8 falls and 6 motor vehicle/bicycle or motorbike accidents. The following were noted: 28 pulmonary contusions, 12 pneumothoraxes, 10 haemothoraxes, 9 rib fractures, 7 haemopneumothoraxes, 5 clavicle fractures and 2 flail chests, 1 diaphragmatic rupture and 1 pneumatocele case. The cut-off value of PTS to discriminate mortality was found to be < or = 4, at which point sensitivity was 75.0% and specificity was 92.5%. Twenty-seven patients were treated non-operatively, 17 were treated with a tube thoracostomy and two were treated with a thoracotomy. Four patients who suffered head and abdominal injuries died (9.09%).
  
  
  CONCLUSIONS
  Thoracic injuries in children expose a high mortality rate as a consequence of head or abdominal injuries. PTS may be helpful to identify mortality in children with blunt chest trauma. Blunt thoracic injuries in children can be treated with a non-operative approach and a tube thoracostomy.
authors.affiliation: Department of Pediatric Surgery, Faculty of Medicine, Trakya University, Edirne, Turkey. mustafainan@trakya.edu.tr
authors.forename: Mustafa
authors.initials: M
authors.lastname: Inan
authors.forename: Suleyman
authors.initials: S
authors.lastname: Ayvaz
authors.forename: Necdet
authors.initials: N
authors.lastname: Sut
authors.forename: Burhan
authors.initials: B
authors.lastname: Aksu
authors.forename: Umit N
authors.initials: UN
authors.lastname: Basaran
authors.forename: Turan
authors.initials: T
authors.lastname: Ceylan
mesh_terms: D000063:Accidents, Traffic; D002648:Child; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013898:Thoracic Injuries / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy