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Handlebar injuries in children

Klimek, Peter ; Lutz, Thomas ; Stranzinger, Enno ; Zachariou, Zacharias ; Kessler, Ulf ; Berger, Steffen

In: Pediatric Surgery International, 2013, vol. 29, no. 3, p. 269-273

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    Titre
    • Handlebar injuries in children
    Auteur
    • Klimek, Peter. Department of Pediatric Surgery, Inselspital, University Hospital and University of Bern, 3010, Bern, Switzerland
    • Lutz, Thomas. Department of Pediatric Surgery, Inselspital, University Hospital and University of Bern, 3010, Bern, Switzerland
    • Stranzinger, Enno. Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, University of Bern, Bern, Switzerland
    • Zachariou, Zacharias. Department of Pediatric Surgery, Inselspital, University Hospital and University of Bern, 3010, Bern, Switzerland
    • Kessler, Ulf. Department of Pediatric Surgery, Inselspital, University Hospital and University of Bern, 3010, Bern, Switzerland
    • Berger, Steffen. Department of Pediatric Surgery, Inselspital, University Hospital and University of Bern, 3010, Bern, Switzerland
    Type de document
    • Postprint
    Langue
    • Inglese
    Publié dans
    • Pediatric Surgery International, 2013, vol. 29, no. 3, p. 269-273. Springer-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:316660
    Summary
    Introduction: Handlebar injuries in children may lead to severe organ lesions despite minimal initial signs and without visible skin bruise. We present our experiences applying a diagnostic and therapeutic algorithm for blunt abdominal trauma, and present the history of two selected cases. Materials and methods: We retrospectively assessed the charts of children below 16years of age, only who were observed for 24h or more in our institution due to a handlebar injury between 2004 and 2011. All children were treated according to an institutional algorithm. Results: 40 patients with a median age of 9.5years were included. Diagnosed lesions were: ruptures of the liver (n=6), spleen (n=5), kidney (n=1), and pancreas (n=2), small bowel perforation (n=3), and hernias of the abdominal (n=2) or thoracic wall (n=1). Surgical interventions were performed in 8 patients. The outcome was favorable in all the cases. Overall median hospitalization duration was 4.5days (range 1-19days). The overall duration between the accident and arrival at our emergency unit was 2.75h (median, range 1-19h). 20 children presented directly at our emergency unit after a median of 1.7h (range 1-19.5h). 20 children were referred by a family physician or a primary hospital after a median of 4.0h (range 1-46h). Conclusion: Handlebar injuries in children resulted in serious trunk lesions in half of the present patient series. The spectrum of injuries in handlebar accidents varies widely, especially injuries to the abdomen can unmask often only in the course. We advocate close observation of patients with thoracic and abdominal handlebar injuries which may be regarded as blunt stab wounds. An institutional algorithm for blunt abdominal trauma management is supportive for emergency care in patients with handlebar injuries