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小儿多发伤患者骨折之间的关系:临床结局评估

THE RELATIONSHIP BETWEEN FRACTURES IN PEDIATRIC POLYTRAUMA PATIENTS: EVALUATION OF CLINICAL OUTCOMES.

作者信息

Carvalho Davi Braga DE, Dobashi Eiffel Tsuyoshi, Gomes Danilo José Leite, Dantas José Manoel, Pajuaba Ana Julia Marquez, Cocco Luiz Fernando

机构信息

Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil.

出版信息

Acta Ortop Bras. 2023 Jul 17;31(3):e268013. doi: 10.1590/1413-785220233103e268013. eCollection 2023.

Abstract

OBJECTIVE

To evaluate children and adolescents with polytrauma and fractures of the pelvis and proximal and diaphyseal femur and correlate the impact of these conditions and clinical outcomes.

METHODS

Retrospective study carried out in a public hospital in Taboão da Serra (SP), with pediatric patients with polytrauma from January 2012 to December 2021. In total, 44 patients were evaluated, 70.44% boys and 29.55% girls, aged from 12 to 17 years.

RESULTS

Diaphyseal fracture of the femur affected 70.44% of the patients, mainly caused by a fall from a height (56.81%). Linear external fixation was the most used treatment (45.45%). All patients were discharged from hospital.

CONCLUSION

We found essential sociodemographic information: 84.11% of patients did not have associated injuries; 88.63% were hospitalized from 3 to 11 days; 90.91% did not need to be admitted to an ICU, 77.27% did not need reoperation, and 22.73% underwent another surgery; 45.45% used the external fixator to stabilize injuries; 11.36% converted the external fixator to the intramedullary nail; 9.09% needed an intramedullary nail remover; 2.27% converted to a plate (bilateral) and 2.27% to a rigid nail; 2.27% had loss of reduction and revision with rod; 2.27% underwent corrective osteotomy; 2.27% had clinical hospitalization; 2.27% had osteonecrosis of the femoral head and screws removed; 2.27% removed the plate. No deaths were recorded.

摘要

目的

评估多发伤且伴有骨盆、股骨近端和骨干骨折的儿童及青少年,并关联这些情况的影响与临床结局。

方法

在圣保罗州塔博昂达塞拉市的一家公立医院开展回顾性研究,研究对象为2012年1月至2021年12月期间患有多发伤的儿科患者。总共评估了44例患者,其中男孩占70.44%,女孩占29.55%,年龄在12至17岁之间。

结果

股骨骨干骨折影响了70.44%的患者,主要由高处坠落所致(56.81%)。线性外固定是最常用的治疗方法(45.45%)。所有患者均已出院。

结论

我们发现了重要的社会人口统计学信息:84.11%的患者无相关损伤;88.63%的患者住院3至11天;90.91%的患者无需入住重症监护病房,77.27%的患者无需再次手术,22.73%的患者接受了另一次手术;45.45%的患者使用外固定器稳定损伤;11.36%的患者将外固定器转换为髓内钉;9.09%的患者需要取出髓内钉;2.27%的患者转换为钢板(双侧),2.27%的患者转换为刚性钉;2.27%的患者出现复位丢失并进行了棒材翻修;2.27%的患者接受了截骨矫正术;2.27%的患者有临床住院情况;2.27%的患者出现股骨头坏死并取出螺钉;2.27%的患者取出了钢板。无死亡记录。

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