Die komplexe Beckenverletzung im Kindesalter

Schmal, Hagen; Klemt, C.; Haag, C.; Bonnaire, F.

doi:10.1007/s00113-001-0401-4

Cited by 17 publications

(8 citation statements)

References 10 publications

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“…[30] Pelvic fractures therefore occur as a result of a high-energy trauma and are often associated with polytrauma. [31,32] An analysis from the American National Inpatient Pediatric Database revealed that children with pelvic injuries presented 5.2 concomitant injuries on average. [33]…”

Section: Discussionmentioning

confidence: 99%

Pelvic fractures in severely injured children

et al. 2018

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Injuries in the pelvic region in children and adolescents are very rare and often associated with a high energy trauma. Aim of this prospective multicenter study was, by analyzing the data from the TraumaRegister Deutsche Gesellschaft für Unfallchirurgie (TR-DGU), to evaluate any correlation between the severity of pelvic fractures and resulting mortality in different age groups.These study findings are based on a large pool of data retrieved from the prospectively-setup pelvic trauma registry established by the German Trauma Society (DGU) and the German Section of the Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF) International in 1991. The registry provides data on all patients suffering pelvic fractures within a 14-year time frame at any 1 of the 23 level 1 trauma centers contributing to the registry. The analysis covers 4 age groups ranging from 0 to 17 years, covering different factors regarding pelvic fractures and their treatment.We identified a total of 9684 patients including 1433 pelvic fractures in children aged ≤17 years. Those patients were divided into 4 subgroups according to the patients' age (groups A-D) and according to the fracture severity (group 1 = Abbreviated Injury Scale (AIS) score pelvis ≤2, and group 2 = AIS pelvis ≥3). The mortality in group 1 was 8.8% with a RISC (Revised Injury Severity Score) II of 8.6%, standard mortality rate (SMR) of 1.02 and 7.2% in group 2 with an RISC II of 9.9% (SMR 0.73). In pelvic factures of Type A (Tile classification of pelvic fractures), an SMR of 0.76 was recorded, in Type B fractures the SMR was 0.65, and in Type C fractures 0.79. Severe pelvic injuries (AIS pelvis ≥2) were associated with a higher rate of whole body computer tomograph (CT) scans (1-5 years: 80%, 6-10 years 81.8%, 11-14 years 84.7%, and 15-17 years 85.6%). The rate of pelvic surgery rose with the pelvic injury's severity (AIS 2: 7.6%, AIS 3: 35%, AIS 4: 65.6%, AIS 5 61.5%). We observed higher rates of preclinical and initial clinical hypotension defined as Riva-Rocci (RR) <90 mmHG) as well as of preclinical fluid application in all age groups. The presence of a pelvic injury was associated with a higher rate of severe abdominal injuries with an AIS of ≥3 (25.1% vs. 14.6%) and of severe thorax injuries with an AIS≥3 (43.6% vs. 28.6%).We have been able to analyze an enormous number of pelvic fractures in children and adolescents including different age groups by relying on data from the TR-DGU. Mortality seems to be associated with the severity of the pelvic injury, but is lower than the RISC II score's prognosis.

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Section: Discussionmentioning

confidence: 99%

Pelvic fractures in severely injured children

et al. 2018

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“…Korrelierend mit der epidemiologischen Entwicklung sank der Anteil der im Beckenregister der DGU dokumentierten Frakturen im Kindesalter von 3,3 % Anfang der 90er-Jahre auf 1,1 % im Zeitraum zwischen 2004 und 2012 [4,5]. Ein durchschnittlicher ISS von 16,7 Punkten weist auf den hohen Anteil an Polytraumen hin [6,7]. Bei den klassischen Überrolltraumata wurden bei 87 % Begleitverletzungen beobachtet, was mit einer Steigerung der Mortalität auf 20 % und einer Komplikationsrate auf über 70 % verbunden war [8].…”

Section: äTiologie Und Epidemiologieunclassified

Beckenverletzungen

Schmal¹

2018

OP-JOURNAL

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ZusammenfassungBeckenfrakturen im Kindesalter sind selten. Das grundsätzliche Verständnis von Instabilität und Klassifikation ist dabei ähnlich dem der Erwachsenen, wobei es jedoch bestimmte Frakturcharakteristika wie das kräftige Periost, die hohe Knochenelastizität und die Wachstumsfugen gibt. Neben der speziellen Physiologie ist dies konsequenterweise bei Diagnostik und Therapie dieser Verletzungen zu berücksichtigen. Dieser Artikel gibt einen Überblick über aktuelle Behandlungskonzepte.

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“…Die unmittelbare Notfallversorgung von kindlichen Beckenringfrakturen unterscheidet sich nicht wesentlich von den etablierten Protokollen zur Versorgung erwachsener Patienten [20].…”

Section: Therapiewahlunclassified