Sridharan Sarup S, You Daniel, Ponich Brett, Parsons David, Schneider Prism
Section of Orthopaedic Surgery, Department of Surgery, University of Calgary, Calgary, Canada.
McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.
J Clin Orthop Trauma. 2020 Nov-Dec;11(6):963-969. doi: 10.1016/j.jcot.2020.10.005. Epub 2020 Oct 15.
Pelvic fractures represent a small proportion of all paediatric fractures, but are likely to be associated with a high-energy mechanism, multiple injuries, and significant morbidity and mortality. Operative fixation of unstable pelvic fractures is accepted. However, there remains a paucity of data on functional outcomes and complications following pelvic fractures in the skeletally immature.
A PRISMA-compliant systematic review was performed, searching Medline, Embase, and Cochrane central review. The primary outcome was functional outcome after pelvic fractures in the paediatric population following operative or non-operative treatment. Secondary outcomes included mechanism of injury, associated injuries, mortality rate, and method of surgical fixation if required. Where possible, weighted totals of the data set were performed.
In total, 23 studies were included in this review. Only eight studies reported functional outcomes, with limb length discrepancy and limp being the most common complication. Only 8.8% of all pelvic fractures underwent surgical fixation. Motor vehicle collision was the most common cause of injury, and extremity fracture was the most common associated injury.
Paediatric pelvic fractures are caused by high-energy mechanisms and have significant morbidity and mortality. There remains a paucity of information on functional outcomes after these injuries.
骨盆骨折在所有儿童骨折中占比小，但可能与高能量机制、多发伤以及显著的发病率和死亡率相关。不稳定骨盆骨折的手术固定是被认可的。然而，关于骨骼未成熟儿童骨盆骨折后的功能结局和并发症的数据仍然匮乏。
进行了一项符合PRISMA标准的系统评价，检索了Medline、Embase和Cochrane系统评价中枢。主要结局是小儿骨盆骨折经手术或非手术治疗后的功能结局。次要结局包括损伤机制、合并伤、死亡率以及必要时的手术固定方法。尽可能对数据集进行加权汇总。
本评价共纳入23项研究。仅有8项研究报告了功能结局，肢体长度差异和跛行是最常见的并发症。所有骨盆骨折中仅8.8%接受了手术固定。机动车碰撞是最常见的损伤原因，四肢骨折是最常见的合并伤。
儿童骨盆骨折由高能量机制导致，具有显著的发病率和死亡率。这些损伤后关于功能结局的信息仍然匮乏。
