Pediatric sacral fractures
Pediatric sacral fractures
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DOI：
10.1097/01.brs.0000115128.36225.e8
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发表时间：
2004-03-15
期刊：
影响因子：
3
通讯作者：
McComb, JG
中科院分区：
文献类型：
--
作者：
Hart, DJ;Wang, MY;McComb, JG
研究设计.回顾性审查。目的。研究儿童骶骨骨折患者的流行病学、解剖学、机制和预后特征，并寻找与成人骶骨骨折文献和先前分类系统的相关性。对目前文献的回顾显示，没有系统地尝试将成人骶骨骨折的研究结果应用于儿童人群。我们回顾了一家儿童医院7年来所有4876例小儿创伤病例。8名儿童有骶骨骨折记录。他们的图表进行了审查，并进行了后续访谈。所有患者都遭遇过机动车事故或从高处坠落的福尔斯。三名患者的损伤局限于骨盆边缘，包括骶骨。平均随访38个月。6例患者发生Denis I区损伤，1例患者发生II区损伤（两种类型均无神经功能缺损），1例患者发生III区损伤伴严重神经功能损伤。只有这名患者需要手术干预。无合并症损伤的患者长期恢复良好。儿童骶骨骨折是罕见的（0.16%的儿童创伤）。与成人的情况一样，大多数骨折与神经损伤无关。诊断小儿骶骨骨折需要高度的临床怀疑和全面的影像学评价。神经损伤与某些骨折类型的相关性可能是可能的，但需要更大规模的研究来证实。
Study Design. Retrospective review.Objectives. To examine the epidemiologic, anatomic, mechanistic, and outcome characteristics in pediatric patients with sacral fractures and to look for correlation with the adult literature regarding sacral fractures and previous classification systems.Summary of Background Data. A review of the current literature reveals no systematic attempts to apply the results of studies of sacral fractures in adults to those in the pediatric population.Methods. We reviewed all 4876 cases of pediatric trauma at 1 children's hospital over a 7-year period. Eight children had documented sacral fractures. Their charts were reviewed, and follow-up interviews were conducted.Results. All patients suffered either motor vehicle accidents or falls from height. Three patients' injuries were confined to the pelvic rim including the sacrum. Mean follow-up was 38 months. Six patients had Denis Zone I injuries, 1 patient had a Zone II injury ( no neurologic deficits in either category), and 1 patient had a Zone III injury with significant neurologic injury. Only this patient required surgical intervention. Long-term recovery was good in those without comorbid injuries.Conclusions. Pediatric sacral fractures are rare (0.16% of pediatric trauma). As is the case in adults, most fractures are not associated with neurologic injury. Diagnosing pediatric sacral fractures requires high clinical suspicion and thorough radiographic evaluation. Correlation of neurologic injury with certain fracture types may be possible, but will require larger studies to be confirmed.