The road traffic accidents are known to make the greatest contribution to the overall structure of pediatric traumatism with the fatal outcome. The problem of pediatric traumatism remains on top of its relevancy despite numerous administrative, legal, technical, and financial measures taken at the government level in an attempt to reduce the mortality rate associated with the child-pedestrian injuries inflicted in the road traffic accidents. The objective of the present study was to summarize and interpret the results published in the scientific literature concerning child-pedestrian injuries inflicted in the road traffic accidents with special reference to the age of the victims and the type of the injury. The analysis of the publications of the domestic and foreign authors has demonstrated that the available data of interest remain to be systematized and that the forensic medical aspects of the problem in question are poorly represented in these materials. It was shown that forensic medical expertises of child-pedestrian injuries inflicted in the road traffic accidents are frequently carried out without taking into consideration the peculiar anatomical and physiological features of the child's organism. The available data concerning the mechanisms and evaluation of severe injuries inflicted to the children in the road traffic accidents are insufficient for the development of the algorithms for the relevant adequate forensic medical expertise. In the light of these findings, the problem of the child-pedestrian injuries inflicted in the road traffic accidents takes on new significance when considered in the context of pediatric traumatism. There is evidently the growing necessity to formulate the universal database containing systematized objective information for the development of new methods of forensic medical expertise for the elucidation of the mechanisms of road traffic injuries inflicted to the children of different age groups depending on the type of the injury and the circumstances of the accident. The embodiment of this idea into an action program would allow to address the problem of child-pedestrian injuries inflicted in the road traffic accidents in the framework of the separate division of forensic medical expertise traumatism.
Цель исследования-установить влияние возраста, местоположения ребенка в салоне и фиксации удерживающими устройствами на особенности повреждений, возникающих в условиях автомобильной травмы у детей-пассажиров. Провели анализ клинического материала. Установили неравнозначное влияние этих факторов на особенности повреждений различных частей тела у детей-пассажиров в условиях дорожно-транспортных происшествий (ДТП). Возраст ребенка оказывает влияние на особенности повреждений всех частей тела. Частота и тяжесть повреждений туловища и костей голени находятся в прямой зависимости от возраста, а переломы бедренной кости и черепно-мозговая травма-в обратной. Плечевая кость и кости предплечья чаще травмируются у детей 3-6 лет. Местоположение ребенка в салоне в момент ДТП также влияет на особенности автомобильной травмы. У пассажиров переднего сиденья чаще встречается тяжелая травмы головы и переломы костей нижних конечностей. У потерпевших, находившихся на заднем сиденье, чаще возникают повреждения туловища и переломы костей верхних конечностей. Фактор фиксации детей удерживающими устройствами влияет на частоту и тяжесть повреждений туловища и нижних конечностей. У таких детей значительно чаще встречаются повреждения внутренних органов груди и живота, переломы костей грудной клетки и таза. При отсутствии фиксации преобладают переломы костей бедра и голени.
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