Dilworth Brian R, Riehl John T
University of Louisville Hospital, Louisville, KY, United States.
Alabama Orthopaedic Clinic.
Int J Surg Case Rep. 2017;36:167-169. doi: 10.1016/j.ijscr.2017.05.029. Epub 2017 May 31.
Pelvic fractures are relatively uncommon in children, accounting for 0.3-7.5% of all pediatric injuries (Gänsslen et al., 2013; Ismail et al., 1996; Peltier, 1965; Galano et al., 2005; Spiguel et al., 2006). This case report describes a pediatric open pelvic injury caused by a crush mechanism between a car and guardrail.
A 13year old male presented with an open APC 3 pelvic injury after being pinned between a car and guardrail. His definitive treatment included bilateral SI screw placement, as well as a less invasive method for anterior pelvic ring disruption (Internal Brace suture anchor dynamic fixation).
DISCUSSION/CONCLUSION: A less invasive method for the anterior pelvic ring was used to avoid additional dissection due to extensive soft tissue loss, and to decrease hardware burden, which lessens the chance of complications such as infection. Suture fixation of the pubic symphysis provided stable fixation to allow healing in the current case of open pelvic fracture.
骨盆骨折在儿童中相对少见,占所有儿科损伤的0.3 - 7.5%(甘斯伦等人,2013年;伊斯梅尔等人,1996年;佩尔蒂埃,1965年;加拉诺等人,2005年;斯皮盖尔等人,2006年)。本病例报告描述了一例因汽车与护栏挤压机制导致的儿童开放性骨盆损伤。
一名13岁男性在被夹在汽车与护栏之间后,出现开放性APC 3型骨盆损伤。其确定性治疗包括双侧骶髂螺钉置入,以及一种用于骨盆前环断裂的微创方法(内支撑缝线锚定动态固定)。
讨论/结论:采用一种骨盆前环的微创方法,以避免因广泛软组织损伤而进行额外的解剖,并减轻内固定负担,从而降低感染等并发症的发生几率。耻骨联合的缝线固定在当前开放性骨盆骨折病例中提供了稳定的固定,以促进愈合。