Effect of age on cervical spine injuries in children after motor vehicle collisions: Effectiveness of restraint devices

被引:17
作者
Zuckerbraun, BS [1 ]
Morrison, K [1 ]
Gaines, B [1 ]
Ford, HR [1 ]
Hackam, DJ [1 ]
机构
[1] Childrens Hosp Pittsburgh, Dept Surg, Div Pediat Surg, Pittsburgh, PA 15213 USA
关键词
cervical spine; trauma; motor vehicle crash; car safety seats; child restraint devices;
D O I
10.1016/j.jpedsurg.2003.11.046
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Purpose: Despite the devastating consequences of cervical spine (C-spine) injury in children after motor vehicle collisions (MVC), the factors leading to the injury and the appropriateness of protective restraints remain undefined. The authors hypothesized that age-related anatomic factors contribute to inadequate restraints and therefore increase injury severity after MVC. Methods: Data on children (<18 years, 1997 to 2002) admitted to a level 1 pediatric trauma center were prospectively collected and retrospectively reviewed. Those with C-spine injuries caused by MVC were extracted and divided into 2 groups: young (0 to 8 years) and old (9 to 18 years). Statistical comparison was by Student's t test or Z-test, with P less than .05 accepted as significant. Results: Of 5,117 trauma admissions, 94 had C-spine injuries with a mean age of 11 +/- 5 years, 66% of which were boys. Among 1,124 patients who had sustained MVC there were 27 C-spine injuries (2.4% incidence), of which, 12 were less than 8 and 15 were older than 8 years. Restraint devices were utilized at least as frequently in younger children (young, 58% v. old, 43%; not significant). However, younger children had an increased incidence of permanent cord deficit (young, 57% v. old, 13%; P < .05) and closed head injury (young, 50% v. old, 7%; P < .05) even while wearing restraint devices, suggesting that restraint devices are inadequate or improperly used in younger patients. This is supported by the increased injury severity scores of the younger group (young, 37.7 +/- 8.5 v. old, 16.5 +/- 4.6; P < .05). Conclusions: Younger children suffer more sever cervical spine injuries after motor vehicle collisions than their older counterparts, in part because of the inadequacy of currently existing restraint devices. Design modifications to current restraints, including the use of head straps, might improve outcome after MVC in younger patients.
引用
收藏
页码:483 / 486
页数:4
相关论文
共 13 条
[1]   Evaluation of pediatric cervical spine injuries [J].
Baker, C ;
Kadish, H ;
Schunk, JE .
AMERICAN JOURNAL OF EMERGENCY MEDICINE, 1999, 17 (03) :230-234
[2]   CERVICAL-SPINE INJURIES IN CHILDREN [J].
BOHN, D ;
ARMSTRONG, D ;
BECKER, L ;
HUMPHREYS, R .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1990, 30 (04) :463-469
[3]   Cervical spine injuries in children: A review of 103 patients treated consecutively at a level 1 pediatric trauma center [J].
Brown, RL ;
Brunn, MA ;
Garcia, VF .
JOURNAL OF PEDIATRIC SURGERY, 2001, 36 (08) :1107-1114
[4]  
Bull MJ, 2002, PEDIATRICS, V109, P550
[5]   Trends in booster seat use among young children in crashes [J].
Durbin, DR ;
Kallan, MJ ;
Winston, FK .
PEDIATRICS, 2001, 108 (06) :art. no.-e109
[6]   Pediatric cervical spine injuries: report of 102 cases and review of the literature [J].
Eleraky, MA ;
Theodore, N ;
Adams, M ;
Rekate, HL ;
Sonntag, VKH .
JOURNAL OF NEUROSURGERY, 2000, 92 (01) :12-17
[7]   Pediatric cervical spine injury: A three-year experience [J].
Givens, TG ;
Polley, KA ;
Smith, GF ;
Hardin, WD .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1996, 41 (02) :310-314
[8]   PEDIATRIC NECK INJURIES - A CLINICAL-STUDY [J].
HILL, SA ;
MILLER, CA ;
KOSNIK, EJ ;
HUNT, WE .
JOURNAL OF NEUROSURGERY, 1984, 60 (04) :700-706
[9]   Characteristics of pediatric cervical spine injuries [J].
Kokoska, ER ;
Keller, MS ;
Rallo, MC ;
Weber, TR .
JOURNAL OF PEDIATRIC SURGERY, 2001, 36 (01) :100-105
[10]   AGE AND OUTCOME IN PEDIATRIC CERVICAL-SPINE INJURY - 11-YEAR EXPERIENCE [J].
ORENSTEIN, JB ;
KLEIN, BL ;
GOTSCHALL, CS ;
OCHSENSCHLAGER, DW ;
KLATZKO, MD ;
EICHELBERGER, MR .
PEDIATRIC EMERGENCY CARE, 1994, 10 (03) :132-137