Paediatric acetabular fractures

Panchani, Sunil; Kumar, Abhishek; Shah, Nikhil; Jones, Harold; Chitre, Amol; Clayson, A.D.

doi:10.1016/j.mporth.2018.07.007

Cited by 2 publications

(4 citation statements)

References 13 publications

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“…The main goals of acetabular fracture management include preservation of joint congruency and stability, while minimizing the disturbance of blood supply [2]. The question becomes whether operative or nonoperative treatment will be the most effective.…”

Section: Discussionmentioning

confidence: 99%

“…However, more recent studies have demonstrated that nonoperative management in the pediatric population has resulted in a high incidence of residual pain, hip instability, growth arrest, limb length discrepancy, and pelvic asymmetry. These studies further demonstrated increased radiographic evidence of post-traumatic acetabular dysplasia, avascular necrosis, delayed union, sacroiliac fusion, and hemipelvic overgrowth [2,[6][7][8][9]. In comparison, a separate article retrospectively reviewed surgical outcomes in pediatric patients with unstable pelvic and acetabular fractures.…”

Section: Discussionmentioning

confidence: 99%

“…Of this small percentage, only 0.8–15% involve fractures of the acetabulum [1] making them a rare form of injury. The pediatric acetabulum is composed of the triradiate cartilage, which consists of the three primary ossification centers of the pelvis [2]. Fractures most commonly occur after triradiate closure which takes place around the age of 12 in females and 14 in males [2, 3] and are usually the result of high-energy trauma.…”

Section: Introductionmentioning

confidence: 99%

“…The pediatric acetabulum is composed of the triradiate cartilage, which consists of the three primary ossification centers of the pelvis [2]. Fractures most commonly occur after triradiate closure which takes place around the age of 12 in females and 14 in males [2, 3] and are usually the result of high-energy trauma. A thorough secondary exam should always be performed in these settings as there are many associated injuries to consider including hip dislocations, related pelvic fractures, intra-abdominal and intrapelvic trauma as well as central nervous system injury.…”

Section: Introductionmentioning

confidence: 99%

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Case Report: Pediatric Posterior Wall Acetabulum with Piriformis Entrapment

Beyer

Klassen

Perry

et al. 2022

Case Rep Orthop Res

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Pediatric acetabular fractures are rare, accounting for only a small percent of pelvic injuries in children. This is a case of a 12-year-old healthy male who sustained a displaced, right posterior acetabular wall fracture following a ground-level fall. It was ultimately determined to be treated through operative management. Intraoperatively, it was noted that the displaced fragment had become trapped posterior to the piriformis muscle. This prompted the surgical release of the piriformis to mobilize the fragment. Afterward, a quarter tubular plate serving as a buttress and multiple cortical screws were placed to secure the fracture. An additional cortical screw and washer were placed for further compression and rotational stabilization. The piriformis was then repaired. The patient was made nonweight bearing for 6 weeks and seen at routine postoperative visits. At 10 weeks postoperatively, the patient had no complaints of pain or difficulty with ambulation and tolerated full range of motion within his right hip. The patient did not return for follow-up, but the mother was contacted at 1 year postoperatively, and she denied any gait or hip range of motion abnormalities within the patient. Unfortunately, no further follow-up was successfully obtained. While most pediatric pelvic injuries can be treated nonoperatively, it has been shown that nonoperative treatment has increased risk of long-term complications. Therefore, surgical consideration remains important as it presents an opportunity for fewer long-term sequelae.

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Section: Discussionmentioning

confidence: 99%