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Pediatric amputation injuries: etiology, cost, and outcome
L C Trautwein1, D G Smith, F P Rivara
1Department of Emergency Medicine, University of Washington, Seattle, USA.
The Journal of Trauma
|November 1, 1996
Summary
Pediatric traumatic amputations, often caused by lawn mowers and car crashes, require extensive medical intervention. Sharp injuries with limited involvement offer the best chance for limb salvage, highlighting the need for safety improvements.
Area of Science:
- Pediatric Trauma Surgery
- Limb Revascularization
- Injury Epidemiology
Background:
- Traumatic amputations in children and adolescents are a significant cause of long-term disability.
- Understanding injury mechanisms and outcomes is crucial for prevention and treatment strategies.
Purpose of the Study:
- To comprehensively profile traumatic amputation injuries in pediatric and adolescent populations.
- To analyze the etiology, treatment, and outcomes of these injuries.
Main Methods:
- Retrospective case series analysis of 74 patients (77 extremities) aged 18 or younger.
- Data collected included injury mechanism, hospital stay, surgical procedures, infection, salvage vs. amputation, and charges.
Main Results:
- Upper extremity injuries (47) were more common than lower extremity (30).
- Power lawn mowers caused 22% of injuries, all resulting in amputation.
- Motor vehicle crashes accounted for 16% of injuries, with 77% leading to amputation.
- Successful salvage (84%) occurred in 27 revascularized extremities, primarily digits in the upper limb.
Conclusions:
- Sharp injuries with minimal tissue involvement are more amenable to successful revascularization.
- Limb salvage success is independent of ischemic time for sharp injuries.
- Lawn mowers pose a significant risk to children, necessitating engineering and educational interventions.