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Trauma

REVIEW OF THE ORTHOPAEDIC MANAGEMENT OF INJURED CHILDREN FOLLOWING THE MANCHESTER ARENA BOMB BLAST

British Limb Reconstruction Society (BLRS) Annual Conference, Southampton, March 2018



Abstract

Introduction

This study reviews the orthopaedic care of the thirteen patients who were admitted and treated at Royal Manchester Children's' Hospital following the Manchester Arena Bomb blast

Methods

We included all children admitted to Royal Manchester Children's Hospital injured following the bomb blast who either suffered upper limb, lower limb or pelvic fractures, or penetrating upper or lower limb wounds. The nature of each patient's bone and soft tissue injuries, initial and definitive management, and outcome were assessed and documented. Main outcome measures were time to fracture union, time to definitive soft tissue/skin healing, and functional outcome.

Findings

Thirteen children were admitted with orthopaedic injuries; 12 were female and mean age was 12.69. All patients had penetrating deep wounds with at least one large nut foreign body in situ, two patients suffered significant burn injury, one patient required amputation of two digits, and two patients required local flap reconstruction. There were a total of 29 upper and lower limb fractures in nine of the patients, with the majority managed without internal or external fixation. In only half of the patients all fractures showed full radiological union at 6 months follow up. There was significant morbidity with several patients suffering long term physical and psychological disability and one patient still in hospital.

Conclusion

We found that stable fractures in children secondary to blast injuries can often be appropriately managed without metalwork, and penetrating wounds can be managed without the need for skin graft/flap reconstruction. Our study documents the severe nature of the injuries suffered by paediatric survivors of the Manchester Arena bomb blast. It highlights the demands on a trauma unit following such an event.


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