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European Journal of Trauma and Emergency Surgery

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01-10-2019 | External Fixator | Original Article

Surgical treatment strategies in pediatric trauma patients: ETC vs. DCO—an analysis of 316 pediatric trauma patients from the TraumaRegister DGU^®

Authors: Klemens Horst, Hagen Andruszkow, Christian David Weber, Miguel Pishnamaz, Matthias Knobe, Felix Marius Bläsius, Philipp Lichte, Rolf Lefering, Frank Hildebrand

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2019

Abstract

Purpose

External fixation within the damage control concept in unstable multiple trauma patients is widely accepted. Literature about its usage in the pediatric trauma population, however, is rare. The aim of the present study was to elucidate the factors associated with the application of external fixation in the severely injured child.

Methods

Patients with severe trauma aged 0–54 years documented in the TraumaRegister DGU^® were included in this study. Demographic data, pattern of injury, injury severity, use of the damage control orthopedics (DCO) or early total care (ETC) concept, duration of mechanical ventilation, intensive care stay, and total hospital stay as well as the occurrence of complications and mortality were evaluated. Statistical evaluation was performed using SPSS (Version 21.0.0) using Chi square tests and linear regression models.

Results

While injury severity was comparable between children and adults, type of accident and injury patterns showed significant differences, Overall, the majority of surgical fracture stabilization in AIS_Extremity ≥ 3 injuries followed the DCO concept in adults (60.3%) and the ETC protocol in children (49.4%). Conservative treatment was chosen for only 11.6% of all children and 9.6% of all adults. An increasing injury severity, AIS_Extremity ≥ 3 and AIS_Extremity ≥ 3 in ≥ 2 body regions, and a more advanced age were found to be independent factors in the use of the DCO concept in children.

Conclusion

Use of external fixation increases with age and plays a minor role in the very young trauma population. However, this does not produce a difference in outcome between children and adults.

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Title: Surgical treatment strategies in pediatric trauma patients: ETC vs. DCO—an analysis of 316 pediatric trauma patients from the TraumaRegister DGU®
Authors: Klemens Horst
Hagen Andruszkow
Christian David Weber
Miguel Pishnamaz
Matthias Knobe
Felix Marius Bläsius
Philipp Lichte
Rolf Lefering
Frank Hildebrand
Publication date: 01-10-2019
Publisher: Springer Berlin Heidelberg
Keyword: External Fixator
Published in: European Journal of Trauma and Emergency Surgery / Issue 5/2019
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-019-01092-7

At a glance: The STEP trials

Springer Medicine

Surgical treatment strategies in pediatric trauma patients: ETC vs. DCO—an analysis of 316 pediatric trauma patients from the TraumaRegister DGU^®

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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