DeFrancesco Christopher J, Sankar Wudbhav N
Division of Orthopaedics, The Children׳s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, Pennsylvania 19104.
Division of Orthopaedics, The Children׳s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, Pennsylvania 19104.
Semin Pediatr Surg. 2017 Feb;26(1):27-35. doi: 10.1053/j.sempedsurg.2017.01.006. Epub 2017 Jan 5.
Although traumatic pelvic fractures in children are relatively rare, these injuries are identified in about 5% of children admitted to level 1 trauma centers after blunt trauma. Such injuries differ from adult pelvic fractures in important ways and require distinct strategies for management. While the associated mortality rate for children with pelvic fractures is much lower than that for adults, the patient may require urgent surgical intervention for associated life-threatening injuries such as head trauma and abdominal injury. Unstable pelvic ring fractures should be acutely managed using an initial approach similar to that used in adult orthopedic traumatology. Although very few pediatric pelvic fractures will ultimately need surgical treatment, patients with these injuries must be followed over time to confirm proper healing, ensure normal pelvic growth, and address any potential complications. The trauma team suspecting a pelvic fracture in a child must understand the implication of such a finding, identify fracture patterns that increase suspicion of associated injuries, and involve pediatric or adult orthopedic specialists as appropriate during the management of the patient.
尽管儿童创伤性骨盆骨折相对少见,但在一级创伤中心因钝性创伤入院的儿童中,约5%被诊断为此类损伤。此类损伤在重要方面与成人骨盆骨折不同,需要不同的处理策略。虽然骨盆骨折儿童的相关死亡率远低于成人,但患者可能因颅脑外伤和腹部损伤等危及生命的相关损伤而需要紧急手术干预。不稳定骨盆环骨折应采用与成人骨科创伤学中相似的初始方法进行紧急处理。尽管最终需要手术治疗的儿童骨盆骨折极少,但必须对这些损伤的患者进行长期随访,以确认愈合情况良好、确保骨盆正常生长并处理任何潜在并发症。怀疑儿童骨盆骨折的创伤团队必须了解这一发现的意义,识别增加相关损伤怀疑的骨折类型,并在患者治疗过程中酌情邀请儿科或成人骨科专家参与。