Are falls more common than road traffic accidents in pediatric trauma? Experience from a Level 1 trauma centre in New Delhi, India

Babu, Annu; Rattan, Amulya; Ranjan, Piyush; Singhal, Maneesh; Gupta, Amit; Kumar, Subodh; Mishra, Biplab; Sagar, Sushma

doi:10.1016/j.cjtee.2015.10.004

Cited by 19 publications

(18 citation statements)

References 19 publications

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“…In the present study, there were 17 boys (60.71%) and 11 girls (39.29%). Similar preponderance of males was found in studies conducted by Ghilley SK et al 13 (64% boys and 36% girls), Baig MS et al 10 (73.3% boys and 26.7% girls), Tandon T et al 14 (54.8% boys and 45.2% girls), Babu A et al 15 (78.6 % were males and 21.3 % were females) and Arora R et al 12 (67% males, 33% females). Male preponderance in all these studies can be attributed to higher level of activity among male children as compared to female children.…”

Section: Discussionsupporting

confidence: 84%

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Outcome of Surgically Managed Diaphyseal Fractures in Children- A Prospective Study

Reddy¹,

Dhaniwala²

2020

jemds

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BACKGROUND Childhood injuries have become a global public health concern. It is estimated that 10-25 % of paediatric injuries are fractures. The definitive treatment of paediatric diaphyseal fractures has always remained controversial and determined by surgical experience and local trends of practice. The aim of this study was to study the outcome of surgically managed diaphyseal fractures in children. METHODS A prospective interventional study was done comprising of 42 fractures in 28 children having displaced diaphyseal fractures of major long bones. Flynn's scoring criteria was used to study the outcome. RESULTS The observations of this study are based on 42 surgically managed diaphyseal fractures in long bones in 28 children. The mean age of patients was 10.85 years. The commonest mode of injury was fall while playing (from level ground) (18 cases, 4.29%). The commonest bones to get fractured were both radius and ulna together (50%), followed by femur (25%), tibia (21.43%) and ulna singly (3.57%). The commonest location of fracture was middle third shaft (25 fractures, 59.52%). Transverse fractures accounted for major proportion of this series. Among the 42 fractures, 39 fractures were treated with titanium elastic nailing and 2 compound fractures were treated with debridement and external fixator application. One 15 year old girl was treated by femur interlock nailing. Among the 25 children who could be followed up, the average follow up period was 22.08 weeks. The mean period of union was 10.69 weeks. Majority of the fractures had excellent outcome (30 fractures, 76.92%), 7 fractures (17.95%) had satisfactory outcome while only 2 fractures (5.13%) had poor outcome. CONCLUSIONS Titanium elastic nailing (TENS) is found to be an effective method of treating closed displaced diaphyseal fractures in children. It is better than plaster cast immobilization due to shorter period required for union, better fracture reduction and stabilization besides prevention of stiffness of adjacent joints and fracture disease. More use of this method is recommended due to these advantages.

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Section: Discussionsupporting

confidence: 84%

“…In a study by Singh O et al, 16 59.40 % patients had history of fall, followed by road traffic accident (32%). Baig MS et al 10 and Babu A et al 15 found the predominant cause to be road traffic accidents. Many other studies also found road traffic accidents to be the predominant cause.…”

Section: Discussionmentioning

confidence: 98%

Outcome of Surgically Managed Diaphyseal Fractures in Children- A Prospective Study

Reddy¹,

Dhaniwala²

2020

jemds

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“…31 This was however in contrast to study by Babu et al and Kundal et al where they found RTA to be the leading cause of trauma, however their study was in predominantly urban set up. 32,33 Incidence of assault injury was slightly higher among female paediatric population compared to male child; this might be because of the girl child are not as preferred as the male child in this part of the country.…”

Section: Discussionmentioning

confidence: 94%

Epidemiology and pattern of paediatric trauma in one of the biggest trauma centres of India

et al. 2020

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Background: The objective of the study was to assess the epidemiology and pattern of trauma in paediatric patients coming to a tertiary care trauma centre in Purvanchal region of country.Methods: Study was conducted at Trauma Centre, Institute of Medical Sciences, BHU. A retrospective data was collected from the emergency entry record book for the paediatric patients coming to emergency with trauma from January to December 2018. A total of 328 patients were included in study. Patient with accidental hanging and those of sexual assault and drowning were not taken in study.Results: Patients in the age group of above 6 years were most numerous 61%. Boys were more commonly injured then girls of same age group with M: F being 1.4:1. Fall was the most common mode of injury overall 45.12% and for the children below 6 years of age 63%. However, RTA was the most common cause in children of above 6 years age group 40.5%, closely followed by fall. Home was found to be the most common location of injury. Females outnumbered males in case of assault injury (7 of 12). Musculoskeletal injury was most common 42%, head injury 27%, polytrauma 12%, while superficial injuries in form of abrasion, contusion etc were 19%. Of all 42% were taken inpatient, 50% discharged on OPD basis and 8% went LAMA. Conclusions: Most of the times the paediatric traumas occur in foreseeable circumstances, most of them occurring at home or around it suggesting the need for more supervision during playing and identification of specific risk factors for these injuries in our setting. Planning of strategies should be according to the epidemiological trends.

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“…There are also accounts of children falling from poorly constructed balconies and windows of which the majority dies and the remaining suffering serious injuries with potential for a long-term disability [27]. In India it was reported that fall from height is the second cause of pediatric head injury next to RTAs [51][52][53]. Incidents of RTAs involving children and teenagers in LMICs are markedly high as compared to the high income countries [54].…”

Section: Common Causes Of Trauma To Children In the Lmicsmentioning

confidence: 99%

Physical Trauma and Its Consequences in Rural and Semi-Urban Regions of Low and Middle Income Countries

Moshi¹

2018

Current Issues in Global Health

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Trauma is a common occurrence in the rural and semi-urban regions of the low-and middleincome countries (LMICs) due to existence of risky infrastructure, socioeconomic, and cultural environments. Causes of trauma in these regions range from the commonest road traffic accidents, falls, burns, and assaults to the scarcely reported range of farmyard accidents. A majority of persons who survive trauma in these areas are evacuated from the incident scene and transported to the health facilities by laypersons by using any available vehicles. This state of handling potentially exposes trauma survivors to secondary injuries, worsening the disability and heightening risk to prehospital death. The cost managing persons with trauma is overwhelmingly high for rural areas of LMICs. Most governments of LMICs are not prepared to cater for individual traumatic incidents; so, if a permanent disability is a final outcome, the injured person and the immediate family have to bear the whole rehabilitation cost. In most cases, these rehabilitation costs are either unaffordable or unavailable to the family leading to provision of inappropriate assistive functional and mobility devices. Broader consequences include the inability to engage in income generating activities, while continuously draining the family economy, hence a poverty-disability vicious cycle.

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Are falls more common than road traffic accidents in pediatric trauma? Experience from a Level 1 trauma centre in New Delhi, India

Cited by 19 publications

References 19 publications

Outcome of Surgically Managed Diaphyseal Fractures in Children- A Prospective Study

Outcome of Surgically Managed Diaphyseal Fractures in Children- A Prospective Study

Epidemiology and pattern of paediatric trauma in one of the biggest trauma centres of India

Physical Trauma and Its Consequences in Rural and Semi-Urban Regions of Low and Middle Income Countries

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