RESUMO
Objective To evaluate and describe musculoskeletal injuries by firearms in children and adolescents attended in a major trauma center. Methods This was a retrospective study that evaluated the medical records of < 18 years old patients who were victims of injuries by firearms and who presented to the emergency department of our hospital, from January 2014 to December 2016. A total of 51 patients were excluded for not showing musculoskeletal injures or for other reasons, while 126 were included. The collected data were: gender; age; way of admission; body site hit; fractures; complications and sequelae; associated injures; hospitalization time; surgeries; deaths. Results Out of 126 patients included, 107 were male (84.9%) and 19 were female (15.1%). The mean age was 15 years and 5 months old (range: 2y + 8 months to 17y + 11 months years old). A total of 70 patients were hospitalized (55.6%), with a mean hospital stay of 9.6 days, and 21 patients were hospitalized in the intensive care unit (ICU) for a mean of 14.7 days. A total of 37 patients needed orthopedic surgery (29.4%). There were 6 deaths (4.8%). The thigh was the most hit region, in 43 injuries (24.7%). Six patients had spinal cord sequelae, and eight patients had peripheral nerves injuries. A total of 58 patients (46%) had 71 fractures, and the femur was the most hit (15.5%). A total of 52 (41.3%) patients presented with associated injuries. In the 71 fractures, the treatment was conservative in 45 (63.4%), surgical in 23 (32.4%). Three injuries resulted in death (4.2%). Conclusion Adolescents and males are at-risk groups for firearms injuries, and the lesions are mainly on the lower limbs. Less than half of the patients had fractures, but many had complex lesions with potential for severe sequelae.
RESUMO
Abstract Objective To evaluate and describe musculoskeletal injuries by firearms in children and adolescents attended in a major trauma center. Methods This was a retrospective study that evaluated the medical records of < 18 years old patients who were victims of injuries by firearms and who presented to the emergency department of our hospital, from January 2014 to December 2016. A total of 51 patients were excluded for not showing musculoskeletal injures or for other reasons, while 126 were included. The collected data were: gender; age; way of admission; body site hit; fractures; complications and sequelae; associated injures; hospitalization time; surgeries; deaths. Results Out of 126 patients included, 107 were male (84.9%) and 19 were female (15.1%). The mean age was 15 years and 5 months old (range: 2y + 8 months to 17y + 11 months years old). A total of 70 patients were hospitalized (55.6%), with a mean hospital stay of 9.6 days, and 21 patients were hospitalized in the intensive care unit (ICU) for a mean of 14.7 days. A total of 37 patients needed orthopedic surgery (29.4%). There were 6 deaths (4.8%). The thigh was the most hit region, in 43 injuries (24.7%). Six patients had spinal cord sequelae, and eight patients had peripheral nerves injuries. A total of 58 patients (46%) had 71 fractures, and the femur was the most hit (15.5%). A total of 52 (41.3%) patients presented with associated injuries. In the 71 fractures, the treatment was conservative in 45 (63.4%), surgical in 23 (32.4%). Three injuries resulted in death (4.2%). Conclusion Adolescents and males are at-risk groups for firearms injuries, and the lesions are mainly on the lower limbs. Less than half of the patients had fractures, but many had complex lesions with potential for severe sequelae.
Resumo Objetivo Avaliar e descrever lesões musculoesqueléticas por armas de fogo em crianças e adolescentes atendidas em um pronto-socorro de grande porte. Métodos Estudo retrospectivo avaliando os prontuários de pacientes, vítimas de armas de fogo e menores de 18 anos de idade que deram entrada ao pronto socorro do nosso hospital, de janeiro de 2014 a dezembro de 2016. Um total de 51 pacientes foi excluído por não apresentar lesões musculoesqueléticas ou outras razões, enquanto 126 foram incluídos. Os dados colhidos foram: sexo; idade; via de entrada; tipo de lesão; balas alojadas e removidas; local do corpo atingido; fraturas; complicações e sequelas; lesões associadas; tempo de internamento e de UTI; cirurgias; e óbitos. Resultados Dos 177 pacientes menores de 18 anos que deram entrada no pronto socorro por ferimento por armas de fogo, 126 pacientes (71,2%) atenderam aos critérios de inclusão. Foram excluídos 51 (43 por não apresentaram lesões musculoesqueléticas). Cento e sete (84,9%) eram do sexo masculino e 19 (15,1%) do feminino. A média de idade foi 15,5 anos (limites, 2 anos + 8 meses a 17 anos + 11 meses). Setenta pacientes foram internados por tempo médio de 9,6 dias, e 21 pacientes foram hospitalizados na unidade de tratamento intensivo (UTI) por 14,7 dias em média. Um total de 37 pacientes (29,4%) foi submetido a cirurgias ortopédicas. Houve um total de 6 óbitos (4,8%). A coxa foi a principal região atingida, em um total de 43 vezes (24,7%). Seis pacientes tiveram lesões da medula espinhal, e oito pacientes tiveram lesões de nervos periféricos. Um total de 58 pacientes (46%) teve 71 fraturas, e o fêmur foi o principal osso fraturado (11 pacientes; 15,5%). Um total de 52 pacientes (41,3%) tiveram lesões associadas. Das 71 fraturas, o tratamento foi conservador em 45 (63,4%) e cirúrgico em 23 (32,4%). Três evoluíram para óbito (4,2%). Conclusão Os adolescentes e o sexo masculino são grupo de risco para lesões de armas de fogo, e as lesões são principalmente em membros inferiores. Menos da metade dos pacientes apresentaram fraturas, mas muitos apresentaram lesões complexas com potencial de graves sequelas.