Mohamed Nusrat, Makaranka Stanislau, Cheema Kamalpreet, Harnett Paul
Orthopaedics, King's College Hospital NHS Foundation Trust, London, UK.
Orthopaedic Surgery, University College London Hospitals NHS Foundation Trust, London, UK.
BMJ Case Rep. 2019 Aug 21;12(8):e230143. doi: 10.1136/bcr-2019-230143.
Bilateral acetabular fractures following epileptic seizures are a rare but known occurrence in adults, with an 18.5% mortality rate. These fractures occurring post epileptic seizures have not been previously documented in children. We report a case of a 13-year-old boy who presented to hospital via ambulance following two violent generalised tonic-clonic seizures in a postictal state, metabolically acidotic and a low haemoglobin. Acute abdomen was suspected and the patient underwent a CT scan which showed bilateral acetabular fractures with central dislocations of both femoral heads and free fluid in the abdomen. The patient underwent initial damage control intervention with insertion of bilateral distal femur skeletal traction. Definitive fixation of the acetabular fractures occurred 1 week later with an open reduction internal fixation with novel supra-pectineal plates using a Pfannenstiel incision. We use this report to increase awareness of significant pelvic injuries in paediatric patients post epileptic seizures.
癫痫发作后双侧髋臼骨折在成人中虽罕见但有报道，死亡率为18.5%。此前儿童癫痫发作后发生此类骨折尚无文献记载。我们报告一例13岁男孩，在两次全身性强直阵挛发作后处于发作后状态，通过救护车送至医院，存在代谢性酸中毒和低血红蛋白。怀疑有急腹症，患者接受了CT扫描，结果显示双侧髋臼骨折伴双侧股骨头中心脱位以及腹腔内游离液体。患者首先接受了双侧股骨远端骨骼牵引的损伤控制干预。1周后采用Pfannenstiel切口，使用新型耻骨上钢板进行切开复位内固定，对髋臼骨折进行了确定性固定。我们通过本报告提高对小儿癫痫发作后严重骨盆损伤的认识。
