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[Clinical assessment of pediatric patients with Waddel's triad]
A I Núñez-Fernádez1, J Nava-Cruz, F Sesma-Julian
1Hospital General de Puebla, SSEP, México.
Insights
Waddell's triad, a femur fracture in children, often involves associated head, chest, or abdominal trauma. These polytraumatized pediatric patients require multidisciplinary care, and the Pediatric Trauma Score effectively indicates injury severity.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
- Emergency Medicine
Context:
- Waddell's triad involves femur fractures in pediatric patients, frequently associated with significant trauma.
- This condition presents an emergency due to the high incidence of associated injuries.
Purpose:
- To clinically assess femur fractures associated with head, chest, and/or abdominal trauma in pediatric patients.
- To evaluate the course of these injuries during hospitalization.
Summary:
- A prospective study included 21 pediatric patients (ages 3-14) with femur fractures and associated trauma.
- Common findings included brain edema, musculoskeletal injuries, and 62% required surgery for thoracic/abdominal trauma. 18 patients needed mechanical ventilation.
- The Pediatric Trauma Score was a reliable indicator of injury severity.
Impact:
- Highlights the critical need for multidisciplinary care in managing polytraumatized pediatric patients.
- Emphasizes the high prevalence of associated musculoskeletal and non-orthopedic injuries in Waddell's triad.
- Underscores the utility of the Pediatric Trauma Score in assessing patient condition.
Introduction:
Waddell's triad represents an emergency for pediatric patients due to the high incidence of injuries associated with the femur fracture.
Objective:
To clinically assess, upon presentation, the femur fracture associated with the head trauma, chest and/or abdominal trauma in the pediatric patients and its course during the hospital stay.
Material And Methods:
Prospective, observational study analyzing the cases that had clinical, imaging and picture records to assess the presence of associated injuries as well as their course during the hospital stay.
Results:
A total of 21 patients were included; 13 boys and 8 girls, ages 3-14 years; weight upon admission was 12-30 kg, the Pediatric Trauma Score range was 1-9 points; 9.6% sustained open fractures; 15 cases had femoral fracture associated with musculoskeletal injuries; the most frequent finding related with head trauma was brain edema. Sixty-two percent of those with thoracic or abdominal trauma warranted a surgical procedure; 18 patients required mechanical ventilation; several methods were used to treat the femur fractures.
Conclusions:
The polytraumatized patients need multidisciplinary care. There is a high percentage of musculoskeletal and non-orthopedic associated injuries in Waddell's triad. The Pediatric Trauma Score is a good indicator of the severity of the patient's condition.
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