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Pediatric Upper Extremity Firearm-related Injuries: A Level I Pediatric Trauma Center Experience.

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Pediatric upper extremity firearm-related injuries (FRI) have surged by 380% in the last decade. Increased injury severity and longer hospital stays are noted, underscoring the need for enhanced firearm safety education.

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Area of Science:

  • Trauma Surgery
  • Pediatric Surgery
  • Public Health

Background:

  • Firearm injuries are a growing concern in the pediatric population.
  • Limited research exists on pediatric upper extremity firearm-related injuries (FRI).
  • This study addresses the gap by examining risk factors, injury severity, and management of pediatric upper extremity FRIs.

Purpose of the Study:

  • To identify demographic and environmental risk factors for pediatric upper extremity FRIs.
  • To evaluate injury severity, associated injuries, and surgical intervention rates.
  • To analyze trends in pediatric upper extremity FRIs over two decades.

Main Methods:

  • Retrospective analysis of 540 pediatric patients (<18 years) with firearm-related injuries from 2001-2020.
  • Focused on 72 patients with upper extremity FRIs, stratified by intervention type and decade of presentation.
  • Collected data on injury characteristics, hospital demographics, length of stay, wound counts, and neurological deficits.

Main Results:

  • A 380% increase in pediatric upper extremity FRIs was observed in the last decade (2011-2020) compared to the previous one.
  • Patients presenting after 2010 had more gunshot wounds per patient but required less ICU admission.
  • Operative intervention was associated with higher rates of soft tissue injury, motor deficits, and longer hospital stays.

Conclusions:

  • The frequency of pediatric upper extremity firearm injuries has significantly increased.
  • Despite increased injury rates, ICU admissions have decreased in the last decade.
  • Continued emphasis on firearm safety education for children is crucial.