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Pediatric Acetabular Fracture

 

synonyms:

Pediatric Acetabular Fracture ICD-9

  • 808.0 (closed)
  • 808.1(open)

Pediatric Acetabular Fracture Etiology / Epidemiology / Natural History

  • Generally result from high energey trauma.

Pediatric Acetabular Fracture Anatomy

  • Triradiate cartilage closes 12.5yrs in girls and 13.5 years in boys.

Pediatric Acetabular Fracture Clinical Evaluation

  • ATLS resuscitation. These can be high enegery injuries, assessment should begin with the A,B,C's.
  • Document neurovascular exam before and after any treatment, especially reduction of dislocated hip.

Pediatric Acetabular Fracture Xray / Diagnositc Tests

  • A/P pelvis, and Judet views (45° iliac and oburator oblique views.)
  • CT scan: assess for posterior pelvic ring injury, femoral head fracture, intra-articular fragments, impaction.

Pediatric Acetabular Fracture Classification / Treatment

  • Watts Classification
  • Type A: dislocation with a small osteochondral fracture
  • Type B: linear non-displaced fracture
  • Type C: displacement of the weight-bearing dome
  • Type D: Central acetabular fracture or dislocation
  • Fractures involving >20% of the posterior wall or >2mm displacement require ORIF.
  • After triradiate cartilage fuses, treat at an Adult Acetabular fracture.

Pediatric Acetabular Fracture Associated Injuries / Differential Diagnosis

Pediatric Acetabular Fracture Complications

  • Osteonecrosis
  • Neurologic injury
  • Infection
  • Poor wound healing
  • Chronic Osteomyelitis
  • Pain
  • Painful hardware
  • Loss of reduction
  • Nonuion
  • Limb length discrepancy
  • Sitting imbalance
  • Gait disturbance
  • DVT / PE

Pediatric Acetabular Fracture Follow-up Care

Pediatric Acetabular Fracture Review References

  • Rockwood and Greens
  • Matta JM: Fracture of the acetabulum: Accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury.  JBJS 1996; 78A: 1632-1645\
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Pediatric Acetabular Fracture

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