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Train injuries in children

P E Blazar1, J P Dormans, C T Born

  • 1Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, USA.

Journal of Orthopaedic Trauma
|February 1, 1997
PubMed
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Pediatric train accident survivors often sustain severe lower extremity amputations requiring multiple surgeries and prolonged care. Prevention through public education and limiting access to railroad areas is crucial.

Area of Science:

  • Trauma Surgery
  • Pediatric Orthopedics
  • Public Health

Background:

  • Train accidents represent a significant cause of severe injury in children.
  • Understanding the specific injury patterns is essential for effective treatment and prevention.

Purpose of the Study:

  • To characterize the types and patterns of injuries in pediatric victims of train accidents.
  • To identify the treatment outcomes and associated costs for these severe injuries.

Main Methods:

  • Retrospective review of 17 pediatric patients treated for train accident injuries between 1984 and 1994.
  • Exclusion of fatalities at the scene and those injured in car-train collisions.
  • Analysis of injury types, surgical interventions, complications, and hospitalization costs.

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Main Results:

  • Eight patients had complete amputations and eight had near-complete amputations, primarily of the lower extremities.
  • Survivors required an average of 5.7 operative procedures during initial hospitalization.
  • 50% of survivors needed secondary surgical procedures, with substantial financial costs averaging $61,000 for acute hospitalization.

Conclusions:

  • Pediatric train accident survivors frequently experience severe, isolated musculoskeletal injuries, predominantly lower extremity amputations.
  • These injuries necessitate extensive surgical management, including multiple debridements and potential amputation revisions.
  • Findings underscore the importance of public education and restricted access to railroad areas for injury prevention.