Car-tire-related Crushing Injury of the Lower Leg in Children

Purpose: Crushing injuries by car tires result from a combination of friction, shearing, and compression forces and the severity of injury is influenced by the acceleration. Because car-tire injuries of the lower leg in children are common these days but they have received little attention; thus, our purpose was to look closely into this problem. Methods: A retrospective analysis was conducted of data from children under 15 years old age who visited an emergency department because of a car-tire-related crushing injury to the lower leg in pedestrian traffic accident from January 2008 to September 2012. The patient's age, sex, site of injury, degree of injury, associated injuries, type of surgery, and complications were reviewed. Results: There were 39 children, the mean age was 8.0 years, and 71.8% were boys. The dorsal part of the leg was involved most frequently. According to the severity classification, 15 children were grade I, 6 were grade II, and 18 were grade III. Among 24 patients, 13 were treated with skin graft and 3 were treated using a sural flap. Twelve patients developed complications, such as hypertrophic scarring, contractures, and deformities with significant bone loss. Conclusion: Various degrees of skin or soft tissue defects were caused in children by car tires. In this study, patients were often also had tendon or bone damage. Proper and timely initial treatments are needed to reduce the incidence of infection, the number of operative procedures, and the hospital stay.

자동차 바퀴에 의한 소아 아래다리의 압궤 손상