Estudo descritivo do trauma ortopédico em crianças e adolescentes atendidas em centro de atendimento nível II

Abstract

Between April 27th 1995 and April 26th 2005, patients with external cause lesions seen at the pediatric orthopedic outpatient clinic of the Maria Amelia Lins Hospital were studied. The objective was to identify the characteristics, patients profile through the variables: age, gender, trauma mechanism, side, topographic localization, associated injuries and compare the epidemiological results with the literature findings. The inclusion criterias were: have a external cause lesion, find the medical records with the appropriate research informations and have open physes. In the above mentioned period 2472 patients were identified, of which 1199 fitted the inclusion criterias. Patients identification and lesion characteristics were taken from the medical records. Age was count in absolute years. Mechanism of trauma were grouped in falls, traffic accidents, direct trauma, others and without information. Thetypes of lesions were divided in amputation, fractures, epiphysiolises, luxations, head trauma, contusions, internal organs injuries, face injuries, and others. Fractures, fracture-luxation, epiphysiolises and luxations were, also, classified as open or closed. Topographic localizationswere classified in relation to bony segments. Patients were grouped in general population, isolated injuries, multiple lesions that had more then one segment and/or of other organs involved. The orthopedic injuries that required more secondary attention were described asprincipal. From the general sample, 838 (68.9%) patients had isolated injuries, 361 (30.1%) patients had 884 multiple lesions. Mean age was 7.6±3.4 years. Masculine gender and the left side predominated. In the isolated injuries the upper limbs were more affected while lowerlimbs were more affected in multiple lesions. The most common trauma mechanisms in general and isolated groups, were falls (39.0% e 44,3%) and traffic accidents in multiple injuries (42,7%). Fracture was the most frequent type of lesion was (73,0% - general sample, 85,3% - isolated injuries and 61,1% - in multiple injuries). Elbow fractures (24%) were the most common topographic localization among the isolated injuries, while leg fractures (12,9%) were the most common among the multiple injuries. One associated injury was seen in 67.% of the multiple lesions 24.3% had two, 5.3% had three and 3.3% had four. Mainly the associationamong elbow fractures and forearm fractures with 25 cases. In conclusion, the descriptive characteristics were the same as the literature. The isolated injury patients´ profile is: boys, inschool age, victims of fall, with upper limb long bone closed fractures. The multiple injury patients´ profile is: boys, at school age, victims of traffic accidents, with lower limb long bone fractures associated with other injuries. Protocols development and introduction are of essential for bias exclusion and comparison in this type of study.