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[Anatomic characteristics of the pelvis in children]
P Lascombes1, G Grosdidier, J Borrelly
1Laboratoire d'Anatomie A, Faculté de médecine, Vandoeuvre.
Insights
Pelvic development involves bone, cartilage, and visceral changes from infancy to adulthood. Understanding these growth-related pelvic modifications is crucial for interpreting imaging and understanding fracture differences.
Area of Science:
- Anatomy
- Pediatrics
- Radiology
Context:
- The pelvis undergoes significant structural and positional changes during growth.
- Neonatal pelvic morphology, including the acetabular labrum, is key for ultrasonography.
- Differences in pelvic fractures between children and adults are linked to developmental changes.
Purpose:
- To detail the ossification, growth, and anatomical modifications of the pelvis from birth to adulthood.
- To correlate pelvic developmental changes with clinical implications like fracture patterns and surgical approaches.
- To aid in the interpretation of pelvic imaging, particularly CT scans, by describing key anatomical structures and their orientations.
Summary:
- Pelvic growth involves ossification centers and changes in volume and mechanical resistance, leading to distinct fracture characteristics in children versus adults.
- Visceral changes include bladder migration from the abdomen to the pubic region and variations in bladder capacity.
- Anatomical descriptions of vascular and nervous structures are provided to aid in understanding cross-sectional imaging.
Impact:
- Provides a comprehensive understanding of pelvic development for clinicians and radiologists.
- Enhances diagnostic accuracy by correlating anatomical changes with imaging findings.
- Informs pediatric orthopedic and urological surgical planning by detailing developmental anatomy.
Abstract:
Growth characterizes the pelvic modifications until adult maturity is reached. Recollection of pelvic ossification is done insisting upon the primary ossification points, the triradiate cotyloid cartilage and the secondary ossification points. The socket's neonatal particular morphology with it's cartilaginous roof and it's fibrocartilaginous acetabular labrum finds it's application in ultrasonography. Bone modifications which occur permanently during growth result in increase of pelvic volume and in modifications of the physical mechanical resistance characteristics so that there are differences between children and adult fractures. Ligamental hyperlaxity and numerous cartilaginous structures are also accountable for these differences. About visceral concern, the main characteristic apart from genital modifications is the apparent migration of the bladder from the neonatal abdominal position down to the adult backward pubic position. Bladder capacity variations have been studied. The male urethra anatomy is recalled from which the different surgical procedures are deduced. The main vasculo nervous axes orientations are described allowing the comprehension of CT scan images. In fact the horizontal plan given by the modern imagery is sometimes difficult to study. An apprentice ship schedule is given following the bone, vasculo-nervous and visceral identification.