Shaath M Kareem, Koury Kenneth L, Gibson Peter D, Adams Mark R, Sirkin Michael S, Reilly Mark C
Department of Orthopaedic Surgery, Rutgers University - New Jersey Medical School, Newark, New Jersey.
J Emerg Med. 2016 Sep;51(3):246-51. doi: 10.1016/j.jemermed.2016.05.031. Epub 2016 Jun 25.
Pediatric pelvic fractures are rare injuries resulting from high-energy mechanisms that warrant an extensive work-up for associated injuries.
We performed a retrospective study to review concomitant injuries in children who suffered a pelvic fracture and have an open triradiate cartilage.
Using a database, pediatric pelvic fractures presenting to the authors' institution were extracted. Radiographs and computed tomography scans were reviewed, ensuring that triradiate cartilages were not fused and the pelvic injuries were classified using the Modified Torode Classification. Epidemiologic data extracted included Glasgow Coma Scale (GCS), Injury Severity Score (ISS), and Abbreviated Injury Score (AIS).
Sixty patients met the inclusion criteria, and their average age was 8.3 years (range 2-14 years). There were no mortalities. The most common mechanism of injury was a vehicle striking a pedestrian. There were no significant correlations between GCS, ISS, and AIS. All 60 children (100%) suffered extremity injuries. Nineteen patients required surgical orthopedic intervention, and 6 required operative stabilization of the pelvis. Patients who were struck by a motor vehicle were more likely to have multiple pelvic fractures (p < 0.05). Patients with multiple pelvic fractures were more likely to require orthopaedic surgical intervention and require a blood transfusion (p < 0.05). Patients who had type III-B or IV fractures were more likely to require a transfusion than patients with III-A fracture (p < 0.05).
Patients sustaining fractures to an immature pelvis are likely to have additional injuries, which may be fatal or disabling if not diagnosed in a timely manner.
小儿骨盆骨折是由高能量机制导致的罕见损伤，需要对相关损伤进行全面检查。
我们进行了一项回顾性研究，以评估骨盆骨折且髋臼软骨未融合的儿童的合并损伤情况。
利用数据库提取本院收治的小儿骨盆骨折病例。回顾X线片和计算机断层扫描图像，确保髋臼软骨未融合，并采用改良的Torode分类法对骨盆损伤进行分类。提取的流行病学数据包括格拉斯哥昏迷量表（GCS）、损伤严重度评分（ISS）和简明损伤评分（AIS）。
60例患者符合纳入标准，平均年龄8.3岁（范围2 - 14岁）。无死亡病例。最常见的损伤机制是车辆撞击行人。GCS、ISS和AIS之间无显著相关性。所有60例儿童（100%）均有肢体损伤。19例患者需要接受骨科手术干预，6例需要进行骨盆手术固定。被机动车撞击的患者更易发生多处骨盆骨折（p < 0.05）。多处骨盆骨折的患者更可能需要骨科手术干预并需要输血（p < 0.05）。Ⅲ - B型或Ⅳ型骨折患者比Ⅲ - A型骨折患者更可能需要输血（p < 0.05）。
未成熟骨盆骨折的患者可能合并其他损伤，如果不能及时诊断，这些损伤可能是致命的或导致残疾。
