Straddle injuries in female children and adolescents: 10-year accident and management analysis

Amulya K Saxena, Maria Steiner, Michael E Höllwarth
Indian Journal of Pediatrics 2014, 81 (8): 766-9

OBJECTIVE: To analyze unintentional straddle injuries in girls with regards to epidemiology, etiology and injury management.

METHODS: The hospital database was retrospectively reviewed (1999-2009) for female patients managed for genital trauma. Patients were evaluated based on age, causative factors, type of injury, area of genitals affected, management and outcomes.

RESULTS: Straddle injuries were documented in 91 girls with age ranging from 1 to 15 y (mean = 6.3 y; median = 6.1 y). The causes of injuries were falls at home (n = 31) or outdoors (n = 27), and sport activities (swimming pool n = 11, skating n = 11, bicycle n = 9 and scooter n = 2). Most of the injuries were lacerations. Injuries involved major labia (n = 56), minor labia (n = 45) and introitus vaginae (n = 15). Twelve children received outpatient treatment. Inspection under anesthesia was performed in 79 patients, with 76 requiring sutures. While hematuria was observed in 18 patients, cystoscopy did not reveal lesions in the urethra or bladder. Associated injuries were femur fracture (n = 1), lower extremity lacerations (n = 4) and anal lesions (n = 2). Follow-up investigations were uneventful; however one patient developed a secondary abscess and another secondary hyperplasia of the labia minor.

CONCLUSIONS: Falls and sports are major causes of straddle injuries with a peak at the age of six years. Lacerations are the most common injuries and often require surgical management. Urinary tract injuries and other associated injuries are relatively uncommon in girls with straddle injuries.

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