This study assessed the types, circumstances, frequency, and health consequences of trauma suffered by juvenile delinquents at a secure residential training school. A review of 369 medical records of 387 teenagers, aged 10 to 17 years, admitted to one such facility between 1978 and 1982 was made. Of the 369 students, 191 students (52%) suffered 391 separate trauma incidents serious enough to require a health care provider's attention. Circumstances surrounding the injuries included sports (36%), fights (20%), self-inflicted injuries (13%), suicide attempts (9%), incidents related to vocational studies (8%), and horseplay (3%). The most common types of injuries were musculoskeletal trauma, scratches, bruises and lacerations, and fractures. The usual sites of injury were the extremities, head, or neck. More than 50% of trauma incidents required a physician's attention initially or in follow-up; 28% of the injured were referred to an off-campus facility; 21% necessitated radiologic or laboratory studies; 4% required hospitalization; and one student died. The average trauma rate for teenagers in this setting was 1.2 injuries per person per year; the average rate of hospitalizations for trauma was 0.04 hospitalizations per person per year. These data call for further studies of trauma morbidity among adolescents in this and other settings and for innovative trauma prevention strategies.

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