Pelvic Avulsion Fractures in Children: a Retrospective Study from Four Trauma Centers
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F25%3A43928297" target="_blank" >RIV/00064173:_____/25:43928297 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11120/25:43928297 RIV/00216208:11130/25:10483930 RIV/00216208:11140/25:10483930 RIV/00669806:_____/25:10483930 and 2 more
Result on the web
<a href="https://doi.org/10.55095/achot2024/045" target="_blank" >https://doi.org/10.55095/achot2024/045</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.55095/achot2024/045" target="_blank" >10.55095/achot2024/045</a>
Alternative languages
Result language
angličtina
Original language name
Pelvic Avulsion Fractures in Children: a Retrospective Study from Four Trauma Centers
Original language description
Purpose of the study: Pelvic avulsion fractures in children are rare and usually associated with sports. The study aimed to evaluate the epidemiology, complications, and displacement cutoff value for surgical treatment. Material and methods: In a retrospective study (2007-2022), we used a group of 201 boys and 20 girls (p < 0.0001). The mean age of boys was 14.9 +- 1.7, and 14.0 +- 1.9 years for girls (p = 0.0129). Injuries included 86 anterior superior iliac spine (ASIS), 83 anterior inferior iliac spine (AIIS), 28 ischial tuberosity (ITU), 13 iliac crest, nine reflected head of the rectus femoris avulsions, and two ipsilateral ASIS + AIIS avulsions. The displacement cutoff value was determined using logistic regression. Complications were assessed using Cox regression and Kaplan-Meier plots. Results: The mean incidence of avulsions was 21 per 1,000,000 children per year. The highest prevalence of osteosynthesis was in ITU (10 out of 28, 35.71%); iliac crest and reflexed head avulsions were treated conservatively. Running was related to the highest risk of ASIS, football for AIIS, and gymnastics for ITU. Most avulsions occurred in September, the fewest in July. Displacement cutoff values were calculated as 10.5 mm for ASIS, 9.5 mm for AIIS, and 14.5 mm for ITU. The most common healing complication was distraction 31 (14.0%), refracture in 2 ITU and non-union in 1 ITU; ITU complications were treated with osteosynthesis. According to the Cox regression, the following items significantly affected outcomes: fracture type (p < 0.0001), early verticalization (p = 0.0062), and initial displacement (p < 0.0001). Discussion: Our study had several limitations, such as it was retrospective, there was a loss of patients from follow-up, and a lack of functional evaluations, for example, using Majeed's score modified for pediatric patients. The positives of the study included a relatively large group of patients from multiple hospitals, the use of logistic regression to determine displacement values to help differentiate between OS and conservative treatment, the inclusion of fracture incidence data, and the inclusion of patients with both surgical and conservative treatment. Conclusions: In the case of ASIS and AIIS avulsions, osteosynthesis can be considered for displacements >= 1 cm and >= 1.5 cm for ITU avulsions. Early verticalization was associated with a lower risk of healing complications in distraction injuries.
Czech name
—
Czech description
—
Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
—
OECD FORD branch
30211 - Orthopaedics
Result continuities
Project
—
Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2025
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Acta Chirurgiae Orthopaedicae et Traumatologiae Čechoslovaca
ISSN
0001-5415
e-ISSN
2570-981X
Volume of the periodical
92
Issue of the periodical within the volume
1
Country of publishing house
CZ - CZECH REPUBLIC
Number of pages
8
Pages from-to
7-14
UT code for WoS article
001460145600001
EID of the result in the Scopus database
2-s2.0-105000473415