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[Acetabulum injuries in infancy and childhood]
1Paediatric Trauma and Orthopaedics, Depatment of Paediatric Surgery, University Children's Hospital, Inselspital, Freiburgstraße, CH-3010, Bern, Schweiz, theddy.slongo@insel.ch.
Insights
Acetabular fractures in infants require specialized care due to unique anatomy. Early MRI and experienced surgical teams are crucial for managing these complex pediatric injuries and preventing growth disturbances.
Area of Science:
- Orthopedic Surgery
- Pediatric Radiology
- Developmental Anatomy
Context:
- Acetabular fractures present unique challenges in infants and young children.
- Anatomical variations in the pediatric acetabulum significantly impact diagnosis and treatment.
- The study focuses on the infantile and childhood stages, excluding older adolescents.
Purpose:
- To detail the anatomical and morphological features of the infant and child acetabulum.
- To highlight the diagnostic difficulties and emphasize the role of advanced imaging like MRI.
- To underscore the importance of specialized surgical expertise and implants for pediatric acetabular fractures.
Summary:
- Presents anatomical and morphological characteristics of the acetabulum in infants and children.
- Advocates for liberal use of MRI, even under anesthesia, for accurate diagnosis in younger children.
- Discusses the risk of growth disturbances (secondary dysplasia) even with optimal treatment and the need for experienced surgical teams.
Impact:
- Informs pediatric orthopedic surgeons and radiologists on critical anatomical considerations.
- Guides the diagnostic approach, promoting earlier and more accurate detection of acetabular injuries.
- Emphasizes the necessity of tailored treatment strategies and experienced surgical management to mitigate long-term complications like secondary dysplasia.
Abstract:
In this article, the anatomical and morphological features of the acetabulum in infancy and childhood are presented. The pathology and treatment of older children and adolescents is deliberately not covered, because the fracture morphology and treatment of patients aged 13 to 15 years is based on the criteria of adult medicine. Especially in the younger child, the anatomical differences are of particular importance. The younger the child is, the more difficult the diagnosis. Therefore today, MRI examinations should be generous used, even if anesthesia is necessary. If the injured child is hemodynamic stable, anesthesia can be electively used for a more complex diagnosis. Acetabular fractures are particularly problematic in infancy because even with optimal treatment and perfect reduction growth disturbances can occur. These manifest as so-called secondary dysplasia. During treatment, care should be taken to ensure that a surgical team having experience with the infant and juvenile skeleton is available and that appropriate implants are available.
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