SEQUELAE OF INJURIES IN ADOLESCENTS - AN EPIDEMIOLOGIC-STUDY

Background. - In all industrialized countries, injuries constitute the primary public health problem during adolescence; study of long-term outcome of injuries to adolescents remains poor. Population and method s. - A longitudinal epidemiological study performed on 8, 140 students in 17 secondary schools in Paris and the Department of the Cote-d'Or followed the development over one year of 777 adolescents who had inju ries in 1990. All injuries, both within and outside school, were inclu ded if they fulfilled the following criteria: school absence or excuse d from vocational training exceeding or equal To 2 days, or excused fr om physical education classes for at feast 14 days. Results. - One yea r after the injury, 13% of the adolescents were still bothered by thei r injury especially those who were older and the girls. Among describe d impairments, musculo-skeletal problems (88% of cases) were the major difficulty. These impairments were primarily in the lower limbs (53%) . Unaesthetic scars were found in 17% of cases, and a psychological im pact was found in 16.5% of the adolescents. The presence of sequelae w as related to the type of initial lesion (present in 24% of head injur ies and in 16% of cases affecting the lower limbs). The most serious d ifficulties were caused by dislocations, serious sprains and fractures . One year after the injury, sequelae were serious in 10% of those ado lescents still experiencing problems; they had some impact on the dail y life of the adolescents in 36% of cases, that is, 5% of all adolesce nts experiencing an injury. These sequelae were responsible for a high level of consumption of medical services. Conclusions. - Although obs erved sequelae were relatively minor, the high frequency of injuries d uring adolescence, as well as their high economic costs, justify the m ost appropriate care available for victims of injuries, even those whi ch appear benign. In addition, longitudinal studies should be prepared using adapted tools (scales for the evaluation of the gravity of inju ry sequelae).