ABSTRACT
Of the 25,301 patients entered into the National Pediatric Trauma Registry (NPTR) between 1985 and 1991, 1553 (6%) had thoracic injuries. Of these, 228 (15%) died (1). One thousand two hundred and eighty-eight had blunt trauma, 230 had penetrating injuries and 35 had other injury mechanisms. Most of the children entered into the NPTR were managed at large trauma centers so these data do not include children with lesser injuries managed at smaller centers. Males are more likely to have thoracic trauma than females, with most series reporting a 3:1 ratio (2-4). Despite its low incidence, thoracic trauma in childhood is second only to severe head injury in lethal potential. Since the cause of death in children with chest trauma is usually not the thoracic injury itself, these injuries are really a marker for the presence of life-threatening multi-system trauma (5-7). This is in keeping with the findings of Holmes’ group that 12% of children with low systolic blood pressure, elevated respiratory rate, abnormal results on chest examination, femur fracture, and a Glasgow Coma Score (GCS) of less than 15 had a thoracic injury, while <1% of children had a thoracic injury when all these features were absent (8).
