Crush Injury in Children: A Retrospective Study from a Tertiary Care Centre in India
Journal Title: Journal of Bone and Joint Diseases - Year 2017, Vol 0, Issue 0
Abstract
Objective: The objective of the study was to study the pattern and outcome of crush injury in children admitted at Level II trauma center of tertiary referral government hospital. Materials and Methods: This is a retrospective study and total 70 pediatric patients with crush injury were included in the study. The demographic data, mode of injury, mode of transport to hospital (direct or referral), time lag between injury and admission to hospital, nature of injury, severity of injury, treatment give, hospital stay, and complications were recorded and analyzed. The severity of crush injury was assessed by mangled extremity severity score with score of 7 or more is highly predictive of amputation. We followed standard pediatric Advanced Trauma Life Support protocol for managing crush injury patients. Results: The average age for all patients was 8.6 years (0–18 years). There were 47 males and 23 females. Multiple trauma including pelvis injury, blunt trauma abdomen, blunt trauma chest, and neurotrauma was present in 36 patients (51.4%). Single limb trauma was present in 34 children’s (48.6%).Compartment syndrome in crush injury was present in 21 cases (30%). Open wound was present in all cases. Crush syndrome was present in 7 patients (10%). The overall case fatality rate was 4.3% (3 patients). Most of patients admitted at hospital between 6 and 24 hrs after trauma (42.85%) and was referred from another hospital(71.4%). Conclusion: Males are at higher risk for all types of injury. Significant number of patients (51.4%) had polytrauma, and almost 30%of patients had neurovascular injury. Despite severe injury, case fatality was seen in only 4.3%.Management of crush injury in children requires aggression and multidisciplinary approach with urgent intervention and restoration of lost tissue or cover to optimize functional outcome. The decision to salvage limb versus amputation in the patient with major limb crush injuries should be individualized.
Authors and Affiliations
Madhusudan Mishra, Ajai Singh, Sourabh Sinha, Sharib Shamim, Ravi Singh Khanka
Keywords
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- EP ID EP508917
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