Paediatric Spinal Injuries in Traffic-Related Incidents
Spinal trauma in children is not common, but the cost is high ? both financially and emotionally, and is most commonly seen as a result of traffic related events. This study aimed to characterise the types and numbers of injuries to the spinal region among children (0-16 years) resulting from traffic incidents. This included motor vehicle occupants, pedestrians, bicyclists, and motorcyclists. A retrospective case review methodology was used. All children 16 years of age and under, treated at the major children?s hospitals in Sydney after sustaining any spinal trauma from a traffic related cause over a five year period, were included. Injury type, severity, and mechanisms were analysed and the changes with age investigated. Data was collected for 101 children. Descriptive analytical techniques were used.
Occupants made up approximately 60% of all spinal injury cases, pedestrians accounted for 17%, and bicycle and motor cycle riders approximately 8% and 15% respectively. There were, however, significant variations in the type of traffic incident leading to spinal injury depending on age. There were also differences in the pattern of injury with age. Minor injuries accounted for 44% of the sample, spinal cord injuries 13%, fractures without cord injury 31% and serious soft tissue injuries (without fracture or cord injury) 12%. Children under 5 years were more likely to sustain serious injuries than older children.
This study demonstrates that in order to reduce traffic-related paediatric spinal injury, addressing protection in child occupants should be the highest priority. There is a particular need for further examination of injury mechanisms in children too big for booster seats. Pedestrians would be the next priority, specifically children less than 5 years. Motorbike crashes accounted for more serious spinal injuries than pedal cycle incidents. Furthermore, the findings suggest that different injury prevention strategies may be required for younger (10 years), and crash factor studies in this area are recommended. In particular there may be a need to examine the relationship between motor coordination development and motorcycle handling in off-road situations.