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Prevention of Childhood Pedestrian Trauma A Study of Interventions over Six Years
Gregory A. Merrell, MD; Jon C. Driscoll, MD; Linda C. Degutis, DrPH; Thomas S. Renshaw, MD
The Journal of Bone & Joint Surgery.  2002; 84:863-867 
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Pedestrian injury is second only to cancer as the leading cause of death of children between the ages of five and nine years 1,2 . Furthermore, pedestrian injury accounts for 31% to 61% of all admissions of children to the hospital for treatment of injuries 3-5 . In the United States, rates of pedestrian injuries among children are estimated to be 111 per 100,000 and account for approximately 18,000 hospital admissions each year 6-8 . In 1996, 1191 children under the age of sixteen were killed in pedestrian-motor vehicle collisions 9 . Operative intervention is required after approximately 11% of pedestrian injuries, and hospital admission is required after 36% 10,11 . Pedestrian injuries are more likely to be severe than are injuries sustained by motor-vehicle occupants, and they are associated with a higher rate of mortality (4% compared with 0.5%) 12 . Mortality is caused by multisystem trauma (80%) or isolated head injury (20%) 13 .
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