Severe blunt thoracic trauma: Differences

47 January 2015, Vol. 105, No. 1 Trauma is a leading cause of death in the developing world, and represents a major burden of disease in South Africa (SA).[1,2] Children are disproportionately affected.[3] Blunt trauma secondary to motor vehicle collisions (MVCs) contributes to the majority of admissions to trauma centres.[4] Significant blunt thoracic trauma in both adults and children requires advanced imaging and critical care support that places strain on a resource-limited healthcare system. Paediatric trauma from MVCs is often multisystem, with a high incidence of thoracic involvement.[5] Paediatric blunt thoracic trauma presents difficulties in both diagnosis and management owing to differences in anatomy.[6] Initial investigations may not reveal significant axial skeletal damage despite high energy transfer and resultant lung contusion, because of the elastic nature of the child’s chest wall. Associated injuries such as rib and sternal fractures are thought to occur less commonly in the paediatric population. Importantly, their absence does not indicate lesser severity of injury. Few articles have investigated the differences in injury pattern between adult and paediatric populations.[6-11] We aimed to review and contrast the incidence and outcome of blunt thoracic trauma among adults and children in a single level I trauma centre over a 6-year period.