Rees M J, Aickin R, Kolbe A, Teele R L
Radiology Department, Middlemore Hospital, Auckland, New Zealand.
Pediatr Radiol. 2001 Jul;31(7):497-500. doi: 10.1007/s002470100473.
Pelvic radiographs are routinely obtained in adult trauma to optimise early management. In adults, pelvic fractures are associated with high early transfusion requirement, high injury severity scores and an increased incidence of other abdominal and thoracic injuries. It is unclear whether this holds true in children.
To determine whether the screening pelvic radiograph is necessary in paediatric trauma.
The notes of all patients who presented after trauma to the Starship Children's Hospital and were triaged to the resuscitation room during 1997 were reviewed. Results of initial radiography were obtained and correlated with later imaging.
Our review of 444 injured children seen over a period of 1 year revealed that of 347 children who had screening pelvic radiographs, only 1 had a pelvic fracture. The fracture in this child was clinically apparent and required no specific treatment.
The presence of a pelvic fracture is rare in injured children. By omitting screening pelvic radiographs there are potential benefits, including reduced radiation exposure to children and cost savings. Uninterpretable or abnormal clinical examination or haematuria requires further investigation, but routine screening for pelvic fracture is unnecessary.
成人创伤时常规拍摄骨盆X光片以优化早期治疗。在成人中，骨盆骨折与早期大量输血需求、高损伤严重度评分以及其他腹部和胸部损伤发生率增加相关。在儿童中情况是否如此尚不清楚。
确定小儿创伤时筛查骨盆X光片是否必要。
回顾了1997年期间因创伤就诊于星舰儿童医院并被分诊至复苏室的所有患者的病历。获取了初始X光检查结果并与后续影像学检查结果进行关联。
我们对1年间诊治的444名受伤儿童的回顾显示，在347名接受骨盆X光片筛查的儿童中，只有1名发生骨盆骨折。该儿童的骨折临床症状明显，无需特殊治疗。
受伤儿童中骨盆骨折少见。省略骨盆X光片筛查有潜在益处，包括减少儿童辐射暴露和节省费用。无法解释或异常的临床检查或血尿需要进一步检查，但常规筛查骨盆骨折并无必要。
