Schwartz G R, Wright S W, Fein J A, Sugarman J, Pasternack J, Salhanick S
Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Ann Emerg Med. 1997 Sep;30(3):249-52. doi: 10.1016/s0196-0644(97)70157-4.
To determine whether history and clinical examination findings can identify young children who have sustained cervical injury after falling short distances.
We conducted a retrospective review of the medical records of children younger than 6 years old with the diagnosis of cervical vertebral fracture or cervical spinal cord injury after a fall of less than 5 feet. Data from medical records over an average time span of 11 years at four large children's hospitals were compiled.
We identified eight children who sustained cervical spine injury after a fall of less than 5 feet. These children ranged in age from 9 to 68 months. Three had rotary subluxation of C1, and three had subluxation of C1-C2. One of the children in the latter group also had an odontoid fracture. Two children had a fracture of C2. All the children had limited range of motion of the neck or neck pain.
All children in this study with the diagnosis of cervical spine injury had clinical evidence of that injury on history or physical examination. Clinicians treating asymptomatic young children who sustain short falls may not need to perform radiographic evaluation of the cervical spine.
确定病史和临床检查结果能否识别出短距离坠落致颈椎损伤的幼儿。
我们对4家大型儿童医院平均11年期间诊断为颈椎骨折或颈椎脊髓损伤且年龄小于6岁的儿童病历进行了回顾性研究。收集了这些病历的数据。
我们确定了8名短距离坠落致颈椎损伤的儿童。这些儿童年龄在9至68个月之间。3例为C1旋转半脱位，3例为C1-C2半脱位。后一组中的1名儿童还伴有齿状突骨折。2名儿童C2骨折。所有儿童均有颈部活动受限或颈部疼痛。
本研究中所有诊断为颈椎损伤的儿童在病史或体格检查中均有该损伤的临床证据。治疗短距离坠落但无症状的幼儿的临床医生可能无需对颈椎进行影像学评估。
