2024, Number 3
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Acta Ortop Mex 2024; 38 (3)
Clinical and functional evaluation of pediatric patients with pelvic fracture treated in a third level Hospital
Ceballos-Jaime M, Ruíz-Mejía O
Language: Spanish
References: 32
Page: 135-141
PDF size: 315.87 Kb.
ABSTRACT
Introduction: pelvic fracture in children is considered one of the most important injuries due to its high mortality. They are rare, but have a major impact on patients' functional outcomes.
Objective: to evaluate the clinical evolution and functional grade in pediatric patients with pelvic fractures who have already been treated, either conservatively or surgically.
Material and methods: descriptive-cross-sectional-retrospective study. Sample of 24 patients, aged five to 16 years with pelvic fracture, treated from 2016 to 2021. Clinical and functional outcome was assessed using the Barthel index and hip range of motion, as well as surgical or conservative treatment, accompanying lesions and injury mechanism.
Results: to find out if there is an association between the Torode and Zieg classifications with the Barthel index and hip range of motion, an association analysis was performed with the χ
2 statistic, obtaining a χ
2 value = 19.213. with p = 0.004 for the Barthel index and a χ
2= 14.253 with p = 0.0026 for hip ranges of motion; these results indicate that there is statistically significant association.
Conclusion: the most frequent type of pelvic fracture in pediatric patients treated is type III on the Torode and Zieg scale, which according to the Barthel index is associated with a degree of independence and complete hip mobility arches, so the clinical and functional outcome in these patients is high in severe injuries.
REFERENCES
Nieto-Lucio L, Camarillo-Martínez A, Camacho-González S, Ceja-Picazo SU, Pérez-Atanasio JM. Reducción cerrada de la articulación sacroilíaca y reconstrucción acetabular en un paciente pediátrico con fractura inestable de pelvis Torode & Zieg IVd. Reporte de un caso. Acta Ortop Mex. 2015; 29(6): 323-7.
Wharton RMH, Trowbridge S, Simpson A, Sarraf KM, Jabbar Y. Anatomic, diagnostic and management challenges in paediatric pelvic injuries: a review. J Pediatr Orthop B. 2019; 28(5): 476-86.
Guillaume JM, Pesenti S, Jouve JL, Launay F. Pelvic fractures in children (pelvic ring and acetabulum). Orthop Traumatol Surg Res. 2020; 106(1S): S125-33.
Shaath MK, Ippolito JA, Adams MR, Sirkin MS, Reilly MC. The role of the computed tomographic scan in the diagnosis of acetabular fracture in the immature pelvis. J Orthop Trauma. 2019; 33 Suppl 2: S32-6.
Amorosa LF, Kloen P, Helfet DL. High-energy pediatric pelvic and acetabular fractures. Orthop Clin North Am. 2014; 45(4): 483-500.
Brunicardi-Hurtado RA, Delgado-Montañez LF. Fractura de pelvis en niños. Repert Med Cir. 2016; 25(3): 168-73.
Leonard M, Ibrahim M, Mckenna P, Boran S, McCormack D. Paediatric pelvic ring fractures and associated injuries. Injury. 2011; 42(10): 1027-30.
DeFrancesco CJ, Sankar WN. Traumatic pelvic fractures in children and adolescents. Semin Pediatr Surg. 2017; 26(1): 27-35.
Shaath MK, Koury KL, Gibson PD, Lelkes VM, Hwang JS, Ippolito JA, et al. Analysis of pelvic fracture pattern and overall orthopaedic injury burden in children sustaining pelvic fractures based on skeletal maturity. J Child Orthop. 2017; 11(3): 195-200.
Omeroglu H. Basic principles of fracture treatment in children. Eklem Hastalik Cerrahisi. 2018; 29(1): 52-7.
Kenawey M, Addosooki A. U-shaped sacral fracture with iliac crest apophyseal avulsion in a young child. J Pediatr Orthop. 2014; 34(5): e6-11.
Vallier HA, Wang X, Moore TA, Wilber JH, Como JJ. Timing of orthopaedic surgery in multiple trauma patients: development of a protocol for early appropriate care. J Orthop Trauma. 2013; 27(10): 543-51.
Spiguel L, Glynn L, Liu D, Statter M. Pediatric pelvic fractures: a marker for injury severity. Am Surg. 2006; 72(6): 481-4.
Monahan PR, Taylor RG. Dislocation and fracture-dislocation of the pelvis. Injury. 1975; 6(4): 325-33.
Lv R, Jin C, Shu H, Wang L, Sa Y. Bladder neck reconstruction in girls' pelvic fracture bladder neck avulsion and urethral rupture. BMC Urol. 2020; 20(1): 179.
Gansslen A, Hildebrand F, Heidari N, Weinberg AM. Pelvic ring injuries in children. Part I: epidemiology and primary evaluation. A review of the literature. Acta Chir Orthop Traumatol Cech. 2012; 79(6): 493-8.
Eberbach H, Hohloch L, Feucht MJ, Konstantinidis L, Sudkamp NP, Zwingmann J. Operative versus conservative treatment of apophyseal avulsion fractures of the pelvis in the adolescents: a systematical review with meta-analysis of clinical outcome and return to sports. BMC Musculoskelet Disord. 2017; 18(1): 162.
Nieto LL, Camacho SG, Reinoso JP. Tratamiento de las fracturas de pelvis inestable tipo IV de la clasificación de Torode y Zieg en niños [Treatment of Torode and Zieg type IV unstable pelvic fractures in children]. Acta Ortop Mex. 2010; 24(5): 338-44.
Holden CP, Holman J, Herman MJ. Pediatric pelvis fractures. J Am Acad Orthop Surg. 2007; 15(3): 172-7.
Grieser T. Radiologische diagnostik von beckenringfrakturen [Radiological diagnosis of pelvic ring fractures]. Radiologe. 2020; 60(3): 226-46.
Chotai N, Alazzawi S, Zehra SS, Barry M. Paediatric pelvic fractures: a review of 2 cohorts over 22 years. Injury. 2018; 49(3): 613-7.
Alhammoud A, Moghamis I, Abdelrahman H, Ghouri SI, Asim M, Babikir E, et al. Clinical characteristics, injury pattern and management of pediatric pelvic fracture: An observational retrospective study from a level I trauma center. BMC Musculoskelet Disord. 2021; 22(1): 626.
Torode I, Zieg D. Pelvic fractures in children. J Pediatr Orthop. 1985; 5(1): 76-84.
Shore BJ, Palmer CS, Bevin C, Johnson MB, Torode IP. Pediatric pelvic fracture: a modification of a preexisting classification. J Pediatr Orthop. 2012; 32(2): 162-8.
Ghanem IB, Rizkallah M. Pediatric avulsion fractures of pelvis: current concepts. Curr Opin Pediatr. 2018; 30(1): 78-83.
Rickert KD, Hosseinzadeh P, Edmonds EW. What's new in pediatric orthopaedic trauma: the lower extremity. J Pediatr Orthop. 2018; 38(8): e434-9.
Roberts J, Uhl RL, Hospodar PP, MacGloin S. Crescent fracture of the pelvis in a 4-year-old child. Orthopedics. 2007; 30(8): 666-7.
Frakes MA, Evans T. Major pelvic fractures. Crit Care Nurse. 2004; 24(2): 18-30; quiz 31-2.
Smith W, Shurnas P, Morgan S, Agudelo J, Luszko G, Knox EC, et al. Clinical outcomes of unstable pelvic fractures in skeletally immature patients. J Bone Joint Surg Am. 2005; 87(11): 2423-31.
Barrero-Solís CL, García-Arrioja S, Ojeda-Manzano A. Índice de Barthel (IB): un instrumento esencial para la evaluación funcional y la rehabilitación. Plast & Rest Neurol. 2005; 4(1-2): 81-5.
Bernaola-Sagardui I. Validation of the Barthel Index in the Spanish population. Enferm Clin (Engl Ed). 2018; 28(3): 210-1. English, Spanish.
Cid-Ruzafa J, Damián-Moreno J. Valoración de la discapacidad física: el índice de Barthel [Disability evaluation: Barthel's index]. Rev Esp Salud Publica. 1997; 71(2): 127-37. Spanish.
EVIDENCE LEVEL
IV