Wang Hongwei, Liu Huan, Zhang Song, Li Changqing, Zhou Yue, Liu Jun, Ou Lan, Xiang Liangbi
Department of Orthopedics, General Hospital of Shenyang Military Area Command of Chinese PLA State Key Laboratory of Robotics, Shenyang Institute of Automation, Chinese Academy of Science, Shenyang, Liaoning State Key Laboratory of Materials Processing and Die and Mould Technology, Huazhong University of Science and Technology, Wuhan, Hubei State Key Laboratory of Trauma, Burn and Combined Injury, Third Military Medical University, Chongqing Department of Orthopedics, Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou Department of Orthopedics Department of Radiology, Xinqiao Hospital Department of Radiology, Southwest Hospital, The Third Military Medical University, Chongqing, China.
Medicine (Baltimore). 2018 May;97(21):e10821. doi: 10.1097/MD.0000000000010821.
To investigate the incidence and pattern of child and adolescent (≤18 years old) traumatic fractures (TFs) as a result of collisions.We retrospectively reviewed 270 child and adolescent patients (228 males and 42 females aged 12.8 ± 5.1 years old) with TFs as a result of collisions admitted to our university-affiliated hospitals from 2001 to 2010. The incidence and patterns were summarized with respect to different age groups, sex, etiology, and whether the patient presented with nerve injury.The most common etiologies were struck by object (105, 38.9%) and wounded by person (74, 27.4%). The most common fracture sites were upper limb fractures (126, 46.7%) and craniofacial fractures (82, 30.4%). A total of 65 (24.1%) patients suffered a nerve injury. The frequency of early and late complications/associated injuries was 35.6% (n = 96) and 8.5% (n = 23), respectively. The mean age (P = .001) and frequency of wounded by person (P = .038) was significantly larger in male than in female patients. The frequency of earthquake injury (P < .001) and lower limb fractures (P = .002) was significantly larger in females than in male patients. The frequency of upper limb fracture was significantly higher in the wounded by machine group (83.3%) than in the other groups (all P < .05). The frequency of lower limb fractures was significantly higher in the earthquake injury group (64.7%) than in the other groups (all P < .05). The frequency of craniofacial fracture was significantly higher in the wounded by person group (54.1%) than in the other groups (all P < .05). The emergency admission rate (P = .047), frequency of wounded by person (P < .001), craniofacial fracture (P < .001), and early complications/associated injuries (P < .001) were significantly larger in patients with nerve injury than in other patients.Struck by object and upper limb fractures were the most common etiology and site, respectively. Wounded by person and craniofacial fractures were risk factors for nerve injury. Therefore, we should pay more attention to patients wounded by person, presenting with craniofacial fracture, to find whether there is nerve injury.
为调查儿童及青少年（≤18岁）因碰撞导致的创伤性骨折（TFs）的发病率及模式。我们回顾性分析了2001年至2010年期间因碰撞导致创伤性骨折而入住我校附属医院的270例儿童及青少年患者（228例男性，42例女性，年龄12.8±5.1岁）。总结了不同年龄组、性别、病因以及患者是否伴有神经损伤情况下的发病率及模式。最常见的病因是被物体撞击（105例，38.9%）和被人致伤（74例，27.4%）。最常见的骨折部位是上肢骨折（126例，46.7%）和颅面骨折（82例，30.4%）。共有65例（24.1%）患者伴有神经损伤。早期和晚期并发症/合并伤的发生率分别为35.6%（n = 96）和8.5%（n = 23）。男性患者的平均年龄（P = 0.001）和被人致伤的频率（P = 0.038）显著高于女性患者。女性患者的地震伤频率（P < 0.001）和下肢骨折频率（P = 0.002）显著高于男性患者。机器致伤组的上肢骨折频率（83.3%）显著高于其他组（所有P < 0.05）。地震伤组的下肢骨折频率（64.7%）显著高于其他组（所有P < 0.05）。被人致伤组的颅面骨折频率（54.1%）显著高于其他组（所有P < 0.05）。伴有神经损伤患者的急诊入院率（P = 0.047）、被人致伤频率（P < 0.001）、颅面骨折（P < 0.001）以及早期并发症/合并伤（P < 0.001）均显著高于其他患者。被物体撞击和上肢骨折分别是最常见的病因和部位。被人致伤和颅面骨折是神经损伤的危险因素。因此，我们应更加关注被人致伤且伴有颅面骨折的患者，以排查是否存在神经损伤。
