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Area of Science:

  • Pediatric Surgery
  • Trauma Management
  • Pediatric Critical Care

Background:

  • Impalement injuries in children are rare but complex, often involving multiple organ systems.
  • Limited comprehensive analyses exist for pediatric populations.

Purpose of the Study:

  • To analyze the characteristics, management, and outcomes of pediatric impalement injuries.
  • To identify factors influencing morbidity and mortality in these cases.

Main Methods:

  • Retrospective review of 21 children (≤12 years) with impalement injuries over 10 years.
  • Inclusion criteria: impaled objects in situ or requiring operative exploration.
  • Data analysis included demographics, injury patterns, surgical management, complications, and outcomes.

Main Results:

  • Accidental injuries most common (81%), with oral cavity and abdomen being frequent sites.
  • Major operative interventions included laparotomies and thoracotomies; 52% required blood transfusions.
  • Complications occurred in 38.1%, with a 14.3% mortality rate, primarily in thoracic/abdominal injuries.

Conclusions:

  • Pediatric impalement injuries necessitate meticulous, multidisciplinary management.
  • Favorable outcomes depend on trauma principles, controlled object removal, and judicious fecal diversion.
  • Early resuscitation and surgical expertise are vital for severe thoracic and abdominal impalements.