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lüll Blunt thoracic trauma in children: review of 137 cases Balci AE; Kazez A; Eren S; Ayan E; Ozalp K; Eren MNEur J Cardiothorac Surg 2004[Aug]; 26 (2): 387-92OBJECTIVE: Thoracic injuries are uncommon in children and few report present on blunt ones. METHODS: Between 1994 and 2003, 137 children with blunt thoracic injury were reviewed. RESULTS: The mean age of children was 6.9+/-7.3 (1-16) years. Etiology was falls in 46.7%, traffical accidents in 51% and abuse in 2.2%. Average height in fallen-down cases was 6.4+/-2 (range: 3-11) m. Calculated mean kinetic energy transfer to body was 1923+/-1056 J. When first seen, 70% (82/117) of the patients had vital signs that were within normal limits. Forty-two (35.9%) children had isolated thoracic injury. Associated injuries were present in 75 (64.1%) children. Head injury was the most common associated injury present in 33 (28.2%). Pulmonary contusion was the most common thoracic injury with 68 (49.6%). Seventeen (12.4%) required surgery, 11 (8%) of them were thoracic (4 for diaphragmatic tear, 2 for flail chest, 2 for tracheobronchial injuries, 2 for laceration, 1 for esophageal rupture). Surgical group had higher ISS (26.8 vs 36.2, P = 0.001). Fifteen were lost (10.9%): There were lethal injuries in 7; chest tube treatment in 3; intensive care unit management in 2; mechanical support in 2 and observation in 1 patient. No death occurred for operations. Mortality rate was the lowest at injuries to chest alone and the highest for multi-system injuries (P < 0.05). The hospital length of stay for averaged 13.4+/-8.8 (range: 4-49) days. CONCLUSION: Associated injury is the most important mortality factor. Thoracic operations can be performed with minimal morbidity and without mortality in children with blunt thoracic trauma.|Adolescent[MESH]|Child[MESH]|Child, Preschool[MESH]|Contusions/therapy[MESH]|Craniocerebral Trauma/mortality/surgery/therapy[MESH]|Critical Care/methods[MESH]|Drainage/methods[MESH]|Female[MESH]|Humans[MESH]|Infant[MESH]|Injury Severity Score[MESH]|Lung Injury[MESH]|Male[MESH]|Multiple Trauma/therapy[MESH]|Retrospective Studies[MESH]|Thoracic Injuries/mortality/surgery/*therapy[MESH]|Wounds, Nonpenetrating/mortality/surgery/*therapy[MESH] |