Traffic Accidents in Children and Adolescents: A Complex Orthopedic and Medico-Legal Approach

Abstract

Traffic accidents involving children and adolescents present complex challenges from both the medico-legal and orthopedic standpoints. Despite the implementation of road traffic safety laws, pediatric road traffic injuries continue to be a significant contributor to mortality rates, physical harm, and hospitalization on a global scale. For children and young people, automobile accidents are considered to be the primary culprit of mortality in developed nations. Even in highly developed nations, trauma is a significant factor in infant mortality. Each age category, from childhood to young adulthood, has its fracture patterns, as their skeletons are considerably different from those of adults. The consequences of traffic accidents extend beyond the immediate physical trauma. The medico-legal aspects surrounding these incidents add another layer of complexity, as legal repercussions may affect the responsible adult or parent, particularly in cases involving child fatalities. To effectively address traffic accidents in children and adolescents, a comprehensive approach is necessary. This approach should involve not only medical professionals but also legal experts and policymakers. Collaboration between orthopedic specialists, medico-legal professionals, law enforcement agencies, and relevant government bodies can facilitate the development and implementation of strategies aimed at prevention, education, the enforcement of traffic laws, and improved infrastructure. By addressing both the medical and legal aspects, it is possible to enhance road safety for children and adolescents, reducing the incidence of injuries and their associated long-term consequences. In this review, we aimed to summarize traffic accidents in children and adolescents from a complex orthopedic and medico-legal approach.

Keywords: adolescents; children; fractures; medico-legal approach; orthopedic approach; road traffic accidents; safety.

Figure 1

Fatalities among children–transport mode differences (2020). Source: CARE, EUROSTAT.

Figure 2

Fatalities among children per million inhabitants aged 0–14 per country in the EU27 (2018–2020). Source: CARE, EUROSTAT.

Figure 3

Fifteen-year-old boy involved in a car accident (pedestrian) who suffered a Gustilo–Anderson type I right distal femur fracture, picture (A,B), which was surgically resolved by open reduction and osteosynthesis with a distal locked femoral plate picture (C,D) at “St. Mary’s” Clinical Emergency Hospital for Children, Iași, Romania, Pediatric Orthopedics Department.