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Shrapnel wounds in children.

M M Hoffer1, B Johnson

  • 1Twelfth Evacuation Hospital of the United States Army, Saudi Arabia.

The Journal of Bone and Joint Surgery. American Volume
|June 1, 1992
PubMed
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Shrapnel-injured children with open fractures treated with debridement and antibiotics showed good healing in most cases. However, some experienced complications, including amputation and one fatality, indicating the severity of such traumatic injuries.

Area of Science:

  • Trauma Surgery
  • Pediatric Orthopedics
  • Wound Management

Background:

  • Open fractures and skin wounds in children due to shrapnel pose significant management challenges.
  • Timely and effective intervention is crucial for optimal patient outcomes.

Purpose of the Study:

  • To evaluate the outcomes of pediatric patients with shrapnel-induced open fractures and significant skin wounds.
  • To assess the efficacy of debridement and antibiotic therapy in managing these injuries.

Main Methods:

  • A cohort of nineteen children with open fractures and skin wounds (≥2 cm) from shrapnel were followed.
  • Management included serial debridement every 24-48 hours and cephalosporin antibiotics.

Main Results:

Related Experiment Videos

  • Fourteen out of nineteen patients demonstrated favorable outcomes with progressive soft-tissue and osseous healing.
  • Three patients with less severe injuries healed well within two weeks.
  • Five patients experienced major complications, including persistent drainage, three amputations, and one death from vascular injury.

    • Conclusions:

    • While debridement and antibiotics are effective for many shrapnel-related pediatric open fractures, a subset of patients face severe complications.
    • Plastic reconstructive procedures may be necessary for complex cases.
    • The high complication rate underscores the critical nature of shrapnel injuries.