Ortega Henry W, Reid Samuel, Velden Heidi Vander, Truong Walter, Laine Jennifer, Weber Libby, Engels James
Emergency Services, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota.
Research and Sponsored Programs, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota.
J Emerg Med. 2014 Aug;47(2):140-6. doi: 10.1016/j.jemermed.2014.04.036. Epub 2014 Jun 11.
Pelvic injuries in young children are rare, and it has been difficult to establish clinical guidelines to assist providers in managing blunt pelvic trauma, especially in non-Level 1 trauma centers.
Our aim was to describe the relationship among clinical findings, mechanism of injury, and the radiographic resources utilized in children with pelvic fractures presenting to a non-Level 1 trauma center.
A retrospective review of patients with a pelvic fracture treated in two urban pediatric Level 3 emergency departments was performed.
Between 2001 and 2010, a total of 208 patients were identified. Avulsion/iliac wing fractures were the most common fractures (58.7%), and sports-related injuries were the most common mechanism of injury (50.0%). Children with sports-related injuries were more likely to sustain an avulsion fracture (p<0.001), less likely to have a computed tomography scan obtained in the emergency department (p<0.001), and less likely to have an associated injury (p<0.001) than other children. Children struck by a motor vehicle (p<0.001) or involved in a motor vehicle accident (p<0.001) were more likely to receive a computed tomography scan (p<0.001) and have associated head and extremity injuries (p<0.001). Mechanism of injury was associated with abnormal computed tomography scans. Nearly all patients were treated nonoperatively (98.1%) and no deaths were reported in this study.
Patterns of injury, based on mechanism of injury, have been reported to assist the assessment and management of children with minor pelvic injuries.
幼儿骨盆损伤较为罕见，难以制定临床指南以帮助医护人员处理钝性骨盆创伤，尤其是在非一级创伤中心。
我们的目的是描述在一家非一级创伤中心就诊的骨盆骨折患儿的临床发现、损伤机制和所使用的影像学检查手段之间的关系。
对在两家城市三级儿科急诊科接受治疗的骨盆骨折患者进行回顾性研究。
2001年至2010年期间，共确定了208例患者。撕脱性/髂骨翼骨折是最常见的骨折类型（58.7%），与运动相关的损伤是最常见的损伤机制（50.0%）。与运动相关损伤的儿童比其他儿童更易发生撕脱性骨折（p<0.001），在急诊科接受计算机断层扫描的可能性较小（p<0.001），且合并其他损伤的可能性较小（p<0.001）。被机动车撞击（p<0.001）或卷入机动车事故（p<0.001）的儿童更有可能接受计算机断层扫描（p<0.001），并伴有头部和四肢损伤（p<0.001）。损伤机制与计算机断层扫描异常有关。几乎所有患者均接受非手术治疗（98.1%），本研究中无死亡报告。
据报道，基于损伤机制的损伤模式有助于评估和处理轻度骨盆损伤的儿童。
