Zhang Hanwen, Zhao Ronghao, Zhu Danjiang, Feng Wei, Song Baojian, Wang Qiang
Department of Orthopedics, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56, Nanlishi Road, Beijing, 100045, P.R. China.
BMC Pediatr. 2025 May 7;25(1):360. doi: 10.1186/s12887-025-05485-z.
To investigate the efficacy of external fixation in treating unstable pelvic fractures in children and identify risk factors for poor prognosis.
A retrospective study was conducted on children with unstable pelvic fractures treated surgically at our hospital from January 2006 to June 2022. All patients received external fixation, and those with vertical instability underwent postoperative limb traction. Data collected included gender, age, injury mechanism, associated injuries, imaging results, operation time, blood loss, pelvic reduction status, complications, and functional recovery. Variables were analyzed using multiple linear regression to explore risk factors for poor prognosis.
The study included 96 patients (62 males, 34 females) with an average age of 95.7 ± 50.3 months. Injury mechanisms were mainly traffic accidents (82.3%) and falls (14.6%). There were 47 cases of Tile B fractures and 49 cases of Tile C fractures. Surgeries were successful with an average operation time of 55.6 ± 27.3 min and blood loss of 6.3 ± 4.7 ml. Immediate postoperative Matta reduction quality was excellent in 91.7% of cases. Postoperatively, 46 patients underwent limb traction for an average of 9.3 ± 1.4 weeks. The average follow-up duration was 29.3 ± 11.7 months, and fracture healing time was 8.6 ± 1.1 weeks. At the final follow-up, 83.3% had excellent or good Cole pelvic function scores. WeeFIM scores indicated complete independence in 71 cases, conditional independence in 13, and conditional dependence in 12. Multiple linear regression identified age, Tile classification, and immediate postoperative displacement as independent predictors of prognosis. Patients aged ≥ 13 years, with Tile C fractures, and immediate postoperative displacement ≥ 8 mm had lower Cole scores.
External fixation combined with lower limb traction effectively treats unstable pelvic fractures in children, with most patients having a favorable prognosis. Assessment of age, fracture type, and reduction quality is essential. Enhanced postoperative follow-up and functional exercises are recommended for older children, those with Tile C fractures, and those with significant immediate postoperative displacement. Clinicians should consider these factors to improve outcomes.
III.
探讨外固定治疗儿童不稳定骨盆骨折的疗效，并确定预后不良的危险因素。
对2006年1月至2022年6月在我院接受手术治疗的儿童不稳定骨盆骨折患者进行回顾性研究。所有患者均接受外固定治疗，垂直不稳定患者术后进行肢体牵引。收集的数据包括性别、年龄、损伤机制、合并损伤、影像学结果、手术时间、出血量、骨盆复位情况、并发症及功能恢复情况。采用多元线性回归分析变量，以探讨预后不良的危险因素。
本研究纳入96例患者（男62例，女34例），平均年龄95.7±50.3个月。损伤机制主要为交通事故（82.3%）和跌倒（14.6%）。Tile B型骨折47例，Tile C型骨折49例。手术均成功，平均手术时间55.6±27.3分钟，出血量6.3±4.7毫升。术后即刻Matta复位质量优良率为91.7%。术后46例患者进行肢体牵引，平均牵引9.3±1.4周。平均随访时间29.3±11.7个月，骨折愈合时间8.6±1.1周。末次随访时，83.3%的患者Cole骨盆功能评分优良。WeeFIM评分显示，71例完全独立，13例有条件独立，12例有条件依赖。多元线性回归分析确定年龄、Tile分型及术后即刻移位为预后的独立预测因素。年龄≥13岁、Tile C型骨折及术后即刻移位≥8毫米的患者Cole评分较低。
外固定联合下肢牵引能有效治疗儿童不稳定骨盆骨折，多数患者预后良好。评估年龄、骨折类型及复位质量至关重要。对于年龄较大的儿童、Tile C型骨折患者及术后即刻移位明显的患者，建议加强术后随访及功能锻炼。临床医生应考虑这些因素以改善治疗效果。
III级
