Patterns of Multi-System Injuries in Paediatric Trauma: Experience from a Sub-Urban Teaching Hospital in Nigeria

Background: Paediatric trauma remains a significant cause of morbidity and mortality worldwide, particularly in low and middle-income countries where trauma systems are underdeveloped. While the causes of paediatric trauma are well documented, there is limited data on the pattern and distribution of multi-system injuries in sub-urban Nigerian settings. Aim: To describe the pattern of multi-system injuries among paediatric trauma patients presenting to a sub-urban teaching hospital in Nigeria. Methods: This was a prospective observational study conducted over one year involving patients aged 18 years and below who presented with traumatic injuries to the accident and emergency unit and surgical outpatient clinic of a sub-urban teaching hospital in the Niger-Delta region of Nigeria. Data collected included age, sex, mechanism of injury, anatomical regions involved, and number of injured systems. Data were analysed using SPSS version 25.0. Results: A total of 139 paediatric trauma patients were studied, comprising 101 males (72.7%) and 38 females (27.3%), with a male-to-female ratio of 2.6:1. Adolescents aged 10-13 years constituted the largest proportion of cases (42.4%). Road traffic accidents were the leading mechanism of injury, accounting for 61.9% of cases, followed by falls from height (15.9%). Multi-system injuries were observed in 79.9% of patients, while 20.1% sustained single-system injuries. The abdomen was the most frequently injured region (83 cases), followed by the head and neck (61), chest (44), skin (41), extremities (39), and perineum (11). Conclusion: Paediatric trauma in this sub-urban Nigerian setting is predominantly characterized by multi-system injuries, with abdominal trauma occurring more frequently than head injuries. These findings underscore the need for improved trauma assessment protocols, early identification of multiple injuries, and strengthened multidisciplinary trauma care. Preventive strategies targeting road traffic injuries and falls remain crucial in reducing the burden of paediatric trauma.