[Fractures of the pelvis in children excluding isolated fractures of the acetabulum and sacrum. Apropos of 267 cases. Anatomic study, contribution of modern radiologic studies, therapeutic management].
This work studies the combined experience of several orthopedic services of 267 pelvic fractures (excluding isolated iliac and sacral fractures) in childhood. The mechanism of these fractures was studied, the majority were the result of road traffic accidents. Among the complications lesions of the urinary tract were most common. Hypotensive states secondary to retroperitoneal bleeding were common but their exact incidence was difficult to estimate accurately. In association with these pelvic lesions it is necessary to emphasize the high incidence of associated cranial, abdominal and skeletal injuries. Computed tomography represents a considerable advance in the assessment of these fractures, demonstrating fractures not visible on standard radiographs and permitting a more precise analysis of displacement. The same type of fractures were in infants as has been reported in adults. However in addition in childhood fractures involving the cartilaginous growth plate are also seen. These include true separation of the growth plate at the triradiate cartilage, the iliac crest and the pubic symphysis. Surgical treatment is only considered for fractures interrupting the pelvic ring and particularly in the context of anterior and posterior column fractures. However, these displaced fractures may leave, contrary to popular opinion sequelae such as leg length discrepancies, ankylosis of the sacro iliac joint, malunited fractures and pain. Therefore it is necessary to adopt a more rigorous attitude in the management of pelvic fractures in the child to avoid these sequelae and to aid in the treatment of associated injuries.
Ducloyer
P
P
Hôpital Trousseau, Service de Chirurgie Pédiatrique, Paris.
Filipe
G
G
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D050723:Fractures, Bone / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D010384:Pelvic Bones / Q000293:injuries*; D011859:Radiography
Les fractures du bassin de l'enfant à l'exclusion des fractures isolées du cotyle et du sacrum. A propos de 267 cas. Etude anatomique, apport des explorations radiologiques modernes, conduite thérapeutique.