Thoracic trauma in children.

Thirty-seven children were admitted for the treatment of thoracic injuries during a 15-year period. Two thirds suffered blunt trauma. Of these children with blunt injuries, three quarters were male, with a median age of 6 years. Half of all victims of blunt trauma were between the ages of 4 and 6 years, and most were involved in motor vehicle crashes. Thirteen children (35%) were victims of penetrating trauma. Sixty-nine percent were male. The median age was 13 years, with 9 of 13 patients in their teenage years. Injuries were evenly distributed between stab and gunshot wounds. Eight of the 37 patients (22%) required thoracotomy. Fourteen had associated intra-abdominal injuries. Twelve of these patients had injuries that required exploratory laparotomy and two were managed expectantly. There were 27 patients with lung injuries, three quarters of whom were managed with tube thoracostomy alone. Seven children suffered injuries that resulted in their deaths. Six had been struck by a motor vehicle. Four of these six died of closed head injuries. The overall mortality of patients with blunt trauma was 25%.