Pediatric Motor Vehicle Trauma

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November 29, 2012
Edward Smith

Kids undergo trauma all the time. In fact, statistics show that trauma from various sources is the leading cause of morbidity and mortality in children. Most kids, about 90 percent, are injured because of blunt trauma. This can be due to a playground injury, a fall from a window or other structure, a motor vehicle accident or an altercation, such as child abuse.

Children can be injured and can sustain a head trauma. The head trauma can occur with or without an obvious skull fracture or open injury. Children have brains that are small in comparison to their skull so that they can break blood vessels or bruise their brain at the site of the injury and at the site opposite to the injury in what’s called a contracoup injury. Children can suffer from confusion after an accident that leads to blunt head trauma or they can be in a coma or persistent vegetative state.

Maxillofacial trauma can happen after a motor vehicle accident. This often involves cuts and scrapes but can involve actual fractures to the mandible, maxillary bone or other bones of the face. These need to be treated by an expert in maxillofacial surgery and there is always possibility that there needs to have surgical intervention to best heal the wound.

Children can have chest trauma in a motor vehicle accident. This often involves rib fractures and the possibility of trauma to the heart or lungs. The presence of an arrhythmia indicates the probability of a cardiac contusion.

Abdominal injuries make up only 10 percent of injuries a child can get in a motor vehicle accident or blunt trauma situation. Doctors need to evaluate the abdomen when the child is in the emergency room for the chance of an abdominal organ or viscus injury. An abdominal ultrasound is perhaps the best diagnostic modality to use in evaluating abdominal trauma in kids. The most injured organ is the spleen, which can be fractured or ruptured. This is followed by injuries to the liver, intestine and pancreas. A child can suffer from pancreatitis due to damage to the pancreas or can hemorrhage from damage to a solid organ. If a viscus ruptures, this can lead to bacteria getting into the abdominal space and to peritonitis.

Most of the time, injuries to the spleen or liver can be treated without surgery. The bleeding eventually stops and the organ eventually heals. Injuries to the intestines involve the probability of surgery as well as injuries to the pancreas. If surgery is done, the person may die of pancreatitis or peritonitis, depending on the organ that is injured.
Pelvic fractures can happen in children involved in motor vehicle accidents but actually femur fractures are more common. Femur fractures involve fractures to the upper bone of the leg. They are much more common in children suffering from a motor vehicle accident when compared to older people, who are more likely to sustain a tibial and fibular fracture.