Imaging in paediatric blast injuries: musculoskeletal injuries in the Syrian Civil War.

To examine the radiological images of children with musculoskeletal injuries and accompanying organ injuries caused by explosions to determine the differences and frequency of injury types and to emphasise the importance of radiology in war injuries.Seventy-four children with injuries caused by bomb explosions were included in the study. The paediatric trauma scores evaluated in the emergency department on the first admission were recorded. All radiographs and computed tomography (CT) images were evaluated for musculoskeletal injuries and accompanying organ injuries.The highest incidence of fracture in the primary blast injury (PBI) group was skull fracture in 15 (62.5%) patients (p=0.01) and fractures in the other groups were most common in the lower extremities. Amputation was observed in nine (31%) patients in the PBI group (p=0.003); however, there were no patients with amputations in the secondary blast injury (SBI) group (p=0.002). The frequency of pneumothorax (79.3%) and pulmonary contusion (59.4%) was high in the PBI group (p<0.001 and p=0.004, respectively). Skull fractures were observed in 15 (88.2%) of 17 patients with brain injury (p<0.001), and skull fractures were the most common fracture site accompanying pulmonary trauma. The average paediatric trauma score of individuals exposed to shrapnel was found to be high (p<0.001).Because paediatric musculoskeletal injuries vary with the type of blast injury and severe trauma can occur in children due to blast effects, radiologists who triage mass injuries should understand the effects of blast injury patterns and the spectrum of injury.