Abstract

ALMEIDA, Miguel. Caracterização epidemiológica das admissões por trauma músculo-esquelético num serviço de urgência pediátrica de um hospital central. Rev. Port. Ortop. Traum. [online]. 2019, vol.27, n.1, pp.31-39. ISSN 1646-2122.

Background: Musculoskeletal trauma is responsible for a large number of emergency hospital admissions in paediatrics. It is the main cause of death and incapacity under 18 years of age. Objective: The aim of this study is to address the lack of medical literature about paediatric musculoskeletal trauma, and its epidemiology in emergency care context. Methods: This is a cross-sectional observational study in which a survey was used for data collection. We selected a convenience sample of the paediatric emergency department admissions in a central hospital, during a 3 month period. Results: A total of 108 admissions were registered. The majority of patients were male and above 10 years old. Accidents happened mainly in school (86.1%), followed by public spaces (7.4%) and home (6.5%). A bigger occurrence of accidents (37%) was recorded between 12:00h and 14:30h. 53.7% were non-sports related accidents, more commonly falls. Wrist and ankle were the most affected joints, 24.7% and 16.7% respectively. Sprains and strains accounted for 52.8% of the diagnoses, while bone fractures accounted for 23.1%. The average permanency time in the emergency care unit was 1 and a half hours. 19.4% of patients were discharged within the first hour after admission. Conclusions: Most children under 10 years of age sought the paediatric emergency care unit due to trauma after falling. Among the ages of 11 and 14 years old, accidents and sports related traumatisms had the same prevalence. Sports related accidents were the main type of accidents in adolescents above 14 years old. Given that the lesions of more than half of patients (52.7%) were probably only minor/superficial, a primary health care evaluation would have been preferable, eventually referring to paediatric emergency care if justifiable.

Keywords : Paediatric musculoskeletal trauma; Traumatism; Accidents; Paediatric emergency; Epidemiology of referrals.

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