Background/Objectives: Injuries remain a major cause of childhood morbidity and mortality in Europe, despite improved prevention. Infants under one year are particularly vulnerable because of limited motor control and complete dependence on caregivers. Existing studies are often small or cover broad age ranges, limiting infant-specific insights. This study aims to provide a comprehensive overview of injury types, mechanisms, and treatments, focusing exclusively on infants aged zero to one year. Methods: This retrospective study analyzed 29,574 infants and children (<2 years) treated at a level 1 trauma department from 1993 to 2022. Primary data included main diagnosis, injury mechanism, and treatment. Injuries were classified by diagnosis and mechanism. Surgeries were categorized by procedure type. Results: Injury frequency increased with age. A total of 31.1% of cases occurred in infants (<12 months) and 68.9% in children (12–24 months). Head injuries were the most common trauma type (44%), particularly among infants (69.9%; children: 32.2%), while wounds (infants: 10.2%; children: 31.5%) and fractures (infants: 4.2%; children: 8.4%) were more frequent in children. Falls were the predominant mechanism (77.9%) across both groups. Most injuries were treated conservatively. A total of 228 surgical interventions were performed (0.8%), mainly for wounds (54.8%) and fractures (30.3%). Conclusions: This study shows that, even within the first two years of life, child development shapes both injury frequency and type. As mobility and independence increase, injuries rise, from predominantly head trauma among infants to a higher incidence of wounds and fractures in children. The majority of injuries were minor and managed conservatively.

Background: Open fractures in pediatric patients are uncommon but clinically relevant, often resulting from high-energy trauma or sports-related incidents. This study analyzes the demographic patterns, types of sports, injury mechanisms, treatment strategies, and outcomes in children and adolescents with sports-related open fractures. Methods: In this retrospective study, 74 pediatric patients with sports-related open fractures treated at a level 1 trauma center between 2002 and 2023 were documented. Parameters such as age, sex, fracture location, sport type, treatment modality, complications, and outcomes were evaluated. Results: The cohort included 74 patients, with a mean age of 13 ± 3.6 years. Open fractures of the upper extremity were most common (seen in 34 patients). Moreover, 10 open craniofacial and 27 open nasal fractures represented 50.0% of injuries, mainly in male athletes involved in contact sports. Soccer was the leading injury-related sport (n = 14; 18.9%). Surgical treatment was required in 28 patients (37.8%), most frequently using elastic stable intramedullary nailing, Kirschner wire fixation in the upper extremities or nasal bone reduction. Antibiotics were administered in 46 patients (62.2%), with a mean documented duration of 2.7 ± 3.1 days. An excellent outcome was documented in 95%. Conclusions: Sports-related open fractures in children primarily affect male adolescents in contact sports and involve the upper extremities and facial region. Conservative management is effective in stable, non-displaced and low-grade injuries. Surgical treatment is frequently indicated in open forearm fractures. The implementation of a structured trauma care protocol, incorporating early debridement, definitive treatment, and antibiotics, has been demonstrated to yield a safe and effective treatment outcome with a favorable prognosis for sports-related open fractures in children.

The growing linguistic diversity among children and their guardians is making language barriers an ever more critical issue in healthcare. Research shows that multiple facets of medical care can be impacted by language barriers. Yet, the potential influence of language barriers in pediatric traumatology remains largely unexplored. In this retrospective case–control study, the parameters adequacy of X-ray diagnostics, treatment duration, unscheduled revisits within 24 h and diagnostic corrections and/or additions were evaluated for a case group (with language barriers) and a control group (without language barriers). The observation period was 2014 to 2023. Language barriers were associated with lower odds of adequate X-ray diagnostics (OR = 0.53, 95% CI 0.30–0.94; p = 0.030), while the difference in treatment duration was small and not statistically significant (+ 2 min, 95% CI − 0.126–4.126; p = 0.066). Diagnostic corrections were more frequent in the language-barrier group (case: 3.0% vs. control: 0.4%; p = 0.045). Twenty-four-hour revisits were similarly low (case: 1.5% vs. control: 0.8%; p = 0.605). Conclusion : Overall, language barriers did not obstruct the treatment process of children aged 0 to 3 years in a trauma care setting despite slight differences. These findings set traumatology apart from other medical fields, potentially due to the clearer visibility of injuries, the efficiency of non-verbal cues, and the focused nature of diagnostic procedures. Targeted communication support and even more standardized diagnostic pathways may help reduce variability. What is Known: • Language-barrier effects have a wide range of effects on the diagnosis and treatment process for pediatric patients in various specialist areas. What is New: • Non-verbal communication forms and clearer injury patterns in traumatology help prevent diagnostic errors. • Language barriers do not clinically impact the treatment of preverbal children in pediatric traumatology.

Background: Pin tract infections (PTIs) are a frequent complication of external fixation, yet pediatric trauma-specific data—particularly for open long bone fractures—remain limited and heterogeneous. This study evaluated the frequency, severity, timing, management, and outcomes of PTIs in children and adolescents treated with external fixation for open long bone fractures. Methods: This retrospective single-center study included patients younger than 18 years with open long bone fractures treated with external fixation between 2002 and 2023. PTIs were graded using the Checketts–Otterburn classification (grades I–VI). Management included antibiotic regimen and surgical interventions. Outcome was reported by time to bony consolidation. Results: In 40 patients, 16 patients exhibited PTIs (mild: eight; moderate: five; severe: three. A higher grade of Gustilo–Anderson (p = 0.47) and evident macroscopic contamination (p = 0.73) did not appear to influence the occurrence of PTIs by similar duration of initial antibiotic regimen (p = 0.3). The median time to PTI onset was 49 days (IQR 22–80), with the majority occurring after completion of initial systemic antibiotic therapy. The management of PTIs was predominantly conservative: all eight mild cases resolved with intensified local pin tract care, while all eight moderate and severe cases were treated with systemic antibiotics and five required pin exchange or premature fixator removal. Overall bony consolidation was achieved in all patients, and reoperations were related to trauma severity rather than PTIs except in one patient. No cases of osteomyelitis were observed. Conclusion: Pin tract infections are frequently identified in pediatric open long bone fractures treated with external fixation. Using strict diagnostic criteria, any documented inflammatory change or local secretion at the pin–skin interface is considered indicative of PTI. However, the majority of these infections were classified as superficial and manageable with conservative measures, and all affected fractures healed radiologically.

Background: Open fractures are traditionally associated with high-energy trauma, such as falls and traffic accidents, in healthy adults. However, the epidemiological characteristics of such injuries in children and adolescents remain incompletely defined. Most studies focus on long-bone injuries, while comprehensive epidemiological data across all anatomical regions are limited. This study aimed to analyze and provide an overview of age-dependent patterns of injury mechanisms and anatomical distribution in pediatric open fractures. Methods: This retrospective cohort study included all open fractures in patients aged 0–18 years treated at a level-I trauma center between 2002 and 2023. Demographic characteristics, injury mechanisms, anatomical distribution, treatment strategies, and complications were analyzed. Results: A total of 814 patients with 849 open fractures were included (mean age 10.5 ± 5.6 years; 67.7% male). Injury mechanisms differed significantly across age groups (p < 0.001), shifting from falls in infants and leisure-related injuries in younger children toward sports-related, traffic-related, and confrontation-related injuries in adolescents. Anatomical distribution also varied significantly with age (p < 0.001). Upper-extremity fractures predominated in younger children, whereas craniofacial fractures increased with age and became the leading anatomical region among adolescents aged 16–18 years (57.7%). Lower-extremity fractures also increased with age, although they accounted for a smaller proportion of fractures overall (14.4%). Across the entire cohort, open fractures most frequently involved the upper extremity (50.1%), followed by the craniofacial region (35.3%). Finger fractures represented the most common injury location (36.3%), followed by nasal fractures (20.6%). Most fractures were managed conservatively (66.8%), while 33.2% underwent surgical treatment. Complications were documented in 15.2% of patients, with surgical treatment required in 50.0% of these cases; septic complications mainly consisted of pin tract infections associated with external fixation. Persistent sequelae occurred in 4.9%, mainly including range-of-motion limitations and pain. Conclusion: Pediatric open fractures showed an age-dependent epidemiological pattern, with upper-extremity injuries predominating in younger children and craniofacial injuries increasing among adolescents. The substantial proportion of craniofacial and distal extremity fractures highlights the importance of considering the full anatomical spectrum of pediatric open fractures beyond long-bone injuries alone.

Background: Behavioral studies show changes and an overall decline in physical activity and general health literacy among children and adolescents. The objective of this study is to analyze and compare the incidence and distribution of leisure-time-related injuries among children and adolescents aged 0–17 years, examining two distinct time periods: 2000–2004 and 2015–2019. Methods: This retrospective analysis was conducted on a cohort of 27,761 children and adolescents who received treatment at our Level-1-Trauma Department due to leisure-time associated activities that occurred between 2000 and 2004 and 2015–2019. Data were stratified by age group, injury type, and anatomical region of injury. Results: The proportion of patients with leisure-related injuries among all injuries per period was significantly lower in the years 2015–2019 (total: 55,971 patients) than in the 2000–2004 period (total: 46,172 patients) (22%; 12,540/55,971 vs. 33%; 15,221/46,173; p < 0.001). Over the past twenty years, adolescents (11–17 years) revealed significantly fewer injuries (63.4%; 9651/15221 in 2000–2004 vs. 50.8%; 6367/12540 in 2015–2019; p < 0.001) while children up to the age of 5 represented an increasingly vulnerable age group (13%; 1975/15221 in 2000–2004 vs. 22.1%; 2771/12540 in 2015–2019; p < 0.001). In both time frames, majority of patients were male. Most common injuries were limb injuries, although age-dependent variations were observed. Conclusion: The findings reveal substantial shifts in pediatric injury patterns and a significant decrease of leisure time injuries in children and adolescents in the investigated time period of 20 years. These trends are indicative of changes in physical activity behaviors and evolving recreational preferences.