Mellick L B, Reesor K
Department of Orthopedics, Tripler Army Medical Center, Oahu, HI.
Am J Emerg Med. 1990 May;8(3):234-7. doi: 10.1016/0735-6757(90)90329-x.
Pediatric training in child abuse has consistently emphasized a strong association between nonaccidental injuries and spiral fractures of long bones. Isolated spiral tibial fractures of childhood have previously been recognized by the orthopedic specialty to most frequently be accidental in etiology. The authors present evidence that supports a predominantly accidental etiology for isolated spiral tibial fractures of young children. This article presents a series in which 9 of 10 such spiral fractures were most likely the result of an accident and not child abuse or gross neglect. Additionally, almost all of these fractures presented as a gait disturbance and should be included in the differential of this complaint.
儿童虐待方面的儿科培训一直强调非意外伤害与长骨螺旋骨折之间存在密切关联。儿童孤立性胫骨螺旋骨折以前在骨科专业领域被认为病因大多是意外。作者提供的证据支持幼儿孤立性胫骨螺旋骨折主要是意外病因。本文介绍了一个系列病例，其中10例此类螺旋骨折中有9例很可能是意外造成的，而非儿童虐待或严重疏忽。此外，几乎所有这些骨折都表现为步态障碍，在对这种主诉进行鉴别诊断时应将其纳入考虑范围。
