|
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\
|
