Acetabular fractures in children and adolescents

Heeg, Minne; Klasen, Henk J.; Jd, Visser

doi:10.1302/0301-620x.71b3.2722933

Cited by 47 publications

(7 citation statements)

References 4 publications

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“…These views should be included with standard hip films, including a frog-leg lateral to rule out femoral neck fracture, SCFE, and other traumatic etiologies of pediatric hip pain. While these views often will not be obtained on initial assessment, studies have shown that pediatric acetabular fractures can be missed on primary radiographs 22% to 80% of the time 6,8,12 , highlighting their importance in this setting. Advanced imaging may be helpful in certain cases; however, it does present certain drawbacks including cost and potential need for sedation.…”

Section: Discussionmentioning

confidence: 99%

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Posterior Wall Acetabular Fracture After Low-Energy Trauma Masquerading as Infection

Compton,

Credille,

Loeffler

et al. 2023

JBJS Case Connector

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Case: A 12-year-old adolescent boy presented after a low-energy fall with groin pain, inability to bear weight, painful passive range of motion, fever, elevated inflammatory markers, and upper respiratory symptoms. Initial radiographs did not demonstrate any abnormality, and magnetic resonance imaging suggested infection. Posterior wall acetabular fracture was not diagnosed until a computed tomography–guided biopsy was performed. Conclusion: Pediatric acetabular fractures are exceedingly rare. They can be difficult to diagnose after low-energy trauma as symptoms mimic infectious hip pathologies. Children presenting with infectious hip symptomology and a history of trauma may benefit from more extensive trauma imaging before costly and invasive infectious diagnostic procedures.

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Section: Discussionmentioning

confidence: 99%

“…assessment, studies have shown that pediatric acetabular fractures can be missed on primary radiographs 22% to 80% of the time 6,8,12 , highlighting their importance in this setting. Advanced imaging may be helpful in certain cases; however, it does present certain drawbacks including cost and potential need for sedation.…”

Section: Discussionmentioning

confidence: 99%

Posterior Wall Acetabular Fracture After Low-Energy Trauma Masquerading as Infection

Compton,

Credille,

Loeffler

et al. 2023

JBJS Case Connector

View full text Add to dashboard Cite

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“…Traditionally, fractures of the pelvis and acetabulum have been treated nonoperatively in children and adolescent patients. 23,24 Von Heyden et al 5 point out that pediatric pelvic and acetabular fractures were historically treated conservatively because of the belief that the thick periosteum, strong ligaments, and significant remodeling potential of the immature skeleton would provide significant fracture stability resulting in acceptable healing. In addition, nonoperative management avoids any chance of iatrogenic injury to the triradiate cartilage, which is important because the closure of the triradiate cartilage typically occurs before 16 years of age.…”

Section: Discussionmentioning

confidence: 99%

Pediatric and Adolescent Fractures of the Acetabulum Treated With ORIF: What Are Their Functional Outcomes?

Southam

Schumaier

Ramalingam

et al. 2022

Journal of Orthopaedic Trauma

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Objectives:To evaluate the functional outcomes of pediatric and adolescent patients (<18 year old) who sustained acetabulum fractures that were treated with open reduction internal fixation (ORIF).Design:Retrospective cohort.Setting:Level 1 trauma center.Patients:Thirty-four pediatric and adolescent patients underwent acetabulum fracture ORIF between 2001 and 2018. Of the operatively treated patients, 21 patients had sufficient follow-up (>6 months), one died after fixation secondary to other traumatic injuries, and 12 patients were lost to follow-up.Intervention:Acetabulum fracture ORIF.Main Outcome Measurement:The SF-36 Health Survey and Short Musculoskeletal Functional Assessment (SMFA) were compared with population norms. The modified Merle d'Aubigné clinical hip score, Matta radiologic outcome, and postoperative complications were also documented.Results:Functional outcome data were available at a mean of 5 years 2 months. Mean SF-36 scores were 44.8 and 50.1 for the physical component score and mental component scores, respectively, which did not differ significantly from US population norms (physical component score mean: 50, P = 0.061 and mental component score mean: 50, P = 0.973). Furthermore, the mean SMFA Bother Index score was 18.6, which is not significantly different from the population norm mean of 13.8 (P = 0.268). However, the function index mean was 31.9, which was significantly worse than the population norm mean of 12.7 (P = 0.001). Two patients with a delayed reduction (>6 hours) of an acetabulum fracture dislocation had poor outcomes related to the development of avascular necrosis and post-traumatic osteoarthritis.Conclusion:In this small cohort, 86% (18/21) of these patients had a favorable functional outcome with the exception of the SMFA Functional Index that was significantly less than population norms. Although long-term follow-up is needed, we advocate for operative management of pediatric and adolescent acetabulum fractures when adult displacement and instability criteria are present.Level of Evidence:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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“…4,5 An important factor to consider in pediatric acetabular fractures is the possibility of physeal injury to the triradiate cartilage, which can lead to growth disturbance of the acetabulum. 3,4,6 The diagnosis is typically established on plan radiographs. The degree of displacement and presence of intraarticular fragments, if suspected, are confirmed on CT.…”

Section: Discussionmentioning

confidence: 99%

Acetabular Fracture in a 16-Year-Old Secondary to an All-Terrain Vehicle Accident

Adams

Attia

2008

Pediatric Emergency Care

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All-terrain vehicles have been associated with a large number of injuries in the pediatric age group. Despite strict regulations governing the sale and manufacture of these vehicles, they continue to be in widespread use. We report a case of a 16-year-old boy with an acetabular fracture secondary to being thrown from an all-terrain vehicle. Acetabular fractures are rare in the pediatric population and are most commonly associated with motor vehicle accidents and other high-energy trauma. Although the diagnosis is straightforward, delayed presentation is not uncommon.

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Acetabular fractures in children and adolescents

Cited by 47 publications

References 4 publications

Posterior Wall Acetabular Fracture After Low-Energy Trauma Masquerading as Infection

Posterior Wall Acetabular Fracture After Low-Energy Trauma Masquerading as Infection

Pediatric and Adolescent Fractures of the Acetabulum Treated With ORIF: What Are Their Functional Outcomes?

Acetabular Fracture in a 16-Year-Old Secondary to an All-Terrain Vehicle Accident

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