News 72

[Madden 21 Barry Sanders]Yi misdiagnosed pelvic fracture: normal line

Update time:2021-06-25 15:56Tag:


  When people are born,The primary bone center of the iliac bone, pubic, and sciatic is accumulated in the hip Y-shaped cartilage (Figure 1).On the X-ray film in the position (Figure 2),Sitting may seem like to be inwardly displaced in the iliac crest.It should not be misdiagnosed as a fracture with Y-shaped cartilage involvement.

  7-12 years old,Y-shaped cartilage gradually thinned (Figure 3),The acetabular top may be irregular,Especially on the axial CT image should not be misdiagnosed as a hip white pulverized fracture (Figure 4).At the age of 11-14,Bone acetabular fusion is an adult acetabular form,Female is earlier in men.

  In adolescence,Three secondary bonization centers around the acetabularIncluding acetabular bone (pubic bone with acetabular), iliac bone (formation of acetabulum on the wall) and a sciatic small bones (Figures 5 and 6)],This increases the acetabular depth.But it may be confused with tearing injury (Figure 7).In adult,The acetabular bone may still be independently small bone blocks,The surface is covered by bone cortex (Figure 8).The humerous body and the humerus wings are developed by several independent primary bone centers (Figure 1),It is usually more incorporated in 1-7 years old.In the early childhood,The ankle joint surface is composed of cartilage.Therefore, the joint gap is relatively widely adult in X-ray planes (Fig. 1).At the time of adolescence,The secondary bonization center of the small triangle appears,Located in the S1 to S3 Horizontal Anti-Imposes Clearance (Fig. 6),It is then incorporated with an outer tibia with an outer tibia.

  Usually before 4-8 years old,Sitting in the shade of osteogenesis can be displayed during unfusion,The width and symmetry of the blade are different in young people (Figure 2,3,9 and 10).


  Like other bones,If you are not familiar with the normal form and variation of bone 骺,It is very difficult to assess child pelvis.Children’s pelvic fractures are rare,It is very important to understand this.In a very small number of cases,The fracture suggests more serious trauma,The risk of concurrency damage is also greater.The pelvic ligament fault and the pelvic ring are uncomfortable,Therefore, children with pelvic injury have little internal fixation.Pelvic damage causes the possibility of large bleeding.But once the pelvic fracture is found,More active inspections should be performed for other systemic damage and take this guidance.Such as potential fatal injuries such as abdominal organs, lungs and head injuries.

  The most common cause of child pelvic trauma is a crash, pedestrians and motor vehicles collide.And the motor vehicle collides with each other.

  Differential diagnosis

  After passive trauma,The normal anatomy and acute fractures of bones are most important,The type of typical fracture associated with mature is helpful for diagnosis.Before the Y-shaped cartilage fusion,An immature pelvic pubic branches and tibia wings are often fractured.After Y-shaped cartilage fusion,Usually in the early days of adolescents,The pelvic structure is approaching maturity.Its fracture mode is similar to adults,That is, acetabular fracture, pubic bone joint separation and the disclosure of the jack.Generally, only a slightly large child (bone pelvic has been mature) is used to cut reset internal fixation.Typical atmosphere is a torn fracture of unfolten bone ends.The most commonly seen from the skeal nodules, the anterior iliac spine, the anterior iliac spine, the above, small rotor and 髂峰.


  The Y-shaped cartilage of the young children, the anecdotic joint, the combination of humerus cartilage and the combination of osteo cartilage may be misdiagnosed as pelvic injury.The secondary bonegen center of larger children may also be misdiagnosed.In particular, the bone center of the acetabular and the ankle joint prior.



  Figure 1 21 month girl,15 feet high peglers.A.The pelvic is in the X-ray flat sheet.The black line outlines the primary bone of the right half pelvic and femur.Normal Y-shaped cartilage (large white arrow), sitting in the shade cartilage binding (white arrow) and the tibia cartilage binding (small white arrow) showing as shown.The width of the ankle joint is normal symmetrical,But more adults wide.B.The tibia level is flat-sweeping CT coronassade-shaped image showing a plurality of osteogenization centers of humerus wings and humerous bones.Unacked blade (black arrow) is normal symmetrical.C.Hip superall coronary restructuring image shows Y-shaped cartilage (black line) normal symmetry


  Figure 2, 4 years old boy,High extract caused by hematoma.The positive × line flat show the pelvis mild right to rotate.The performance is the left closed hole ring,The right bar is flattened.Bilateral ankle joint and sitting osteo cartilage binding due to pelvic rotation,No acute fracture or dislocation signs



  Figure 3 6 years old girl,Motor vehicle accident.A.The pelvic positivity X-ray flat icon is shameless branch morphology irregular (black arrow),May be confused with fractures.Y-shaped hose has not been fused,But it has narrowed.B.The pelvic subtraction CT bone window image confirmed that this is normal to sit as to the bone combination (black arrow),No acute trauma



  Figure 4 8 years old boy,The whole topographic vehicle was injured.A.The pelvic axis is flat-sweeping CT bone window shows the fragmentary appearance of normal left hip top.The performance of the right acetabulum on other levels is similar (not shown).This case misdiagnosed as the possibility of hip day fractures.Left acetabular (b) and outer side (C) sagittal recombinant image Shows normal sitting on the left side of the acetabers (black arrow), a shame plate (white arrow), sitting on the plateWhite line).D.The pelvic crown restructuring image shows the levels of Figures a, b, and c




  Figure 5 11 year old girl,Motor vehicle accident.A.Pelvic positivity X-ray flat screen display bilateral acetabular upper (white arrow) symmetrical translucent line and right iliac bone translucent line (black arrow).The left tibia outer edge is blocked by the traumatic backplane and displayed.B.The CT coronary restructuring shows the bilateral residual situations (white arrows), acetithoconitic bonization center (white arrow).C.Ampathite CT image,Double-sided sitting on the secondary bonization center (black arrow) of normal symmetrical,Corresponding to the translucent line of the right tibia




  Figure 6 15 years old male,Improving when playing football.A.Standardized Pelvic CT 3D volume reorganization of the developmental anatomical characteristics of the pelvic normal.

  The right tibia is completely bone, but it has not been fused.Symmetrical with the left side.Sit bone nodules are displayed in front view (white arrow).The left ankle joint mild irregularities (*),One of the normal variations of adolescents.Pelvic CT three-dimensional volume re-reorganization exit (B), inlet position (C) and 45 degrees oblique (D) image,From different angles, the 骨 (white arrow) and the sciatic nodules (white arrow) are shown.E.The radial axial bone window image shows the iliac artation and the post-reusstal (white arrow), the tibial bone center (black arrow).F.Sit bone nodes level axis image display Sit bone nodules (white arrow) are not fused.Irregularity of the pubic bone (*)But still within the normal range


  Figure 7 14-year-old boy,Motor vehicle accident.The pelvic is in the X-ray flat sheet.On the left side of the acetab, there is a bone sheet (black arrow),The acetabular bone and hip joint degree with acetabular end fracture should be identified


  Figure 8 27 years old,stomach ache.CT coronary reorganized bone window image accidentally found left acetabular (white arrow)


  Figure 9 2 years old boy,Pain after falling.The pelvic X-ray flat screen shows that the combination of osteo cartilage is wide.But the form is symmetrical.Black line outlines the right side and pubic,Only inner cartilage bonding on the positive X-ray plane is clearly displayed


  Figure 10 9 years old boy,Horse tick.The pelvic pelvis X-ray flat screen shows the right side shameless line (black arrow) asymmetry,But no acute fracture


  [1]Silber JS,Flynn JM.CHANGING PATTERNS OF PEDIATRIC PELVIC FRACTURES WITH SKELETAL MATURATION: IMPLICATIONS for Classification and Management.J PediaTr Orthop,2002,22 (1): 22-26.

  [2]Ponseti IV.Growth and development of the acetabulum in the normal child.Anatomic,Histological,And ROENTGRAPHIC STUDIES.J Bone Joint Surg,1978,60A (5): 575-585.

  [3]Keats TE,Anderson MW.Atlas of Normal ROENTGEN VARIANTS THAT May Simulate Disease,8th edn.Philadelphia: Mosby Elsevier,2007.

  [4] Gotz W, Funke M, Fischer G, ET Al. Epiphysial OSSIFICATION CENTRES in IliosCral Joints: Anatomy and Compute Tomography. Surg Radiol ANAT,1993,15 (2): 131-137.

  [5] Banerjee S, Barry MJ, Paterson JM. Pediatric Pelvic Fractures: 10 Years Experience In A Trauma Center.Injury,2009,40 (4): 410-413.

  [6] Rossi F, Dragoni S. Acute avulsion fractures of thepelvis in adolescent Competitive Athletes: Prevalence, Location and Sports Distribution Of 203 Cases Collected.SkeleTal Radiol,2001,30 (3): 127-131.

  [7] Sanders TG, Zlatkin MB. Avulsion injuries of the Pelvis. Semin Musculoskelet Radiol,2008,12 (1): 42-53.

  Source: Radios

  [Copyright Notice]This platform is a public welfare learning platform.The reprint is out of the purpose of passing more learning information.And have indicated the author and the source,If you don’t want to be spread, you can contact us to delete.

recommended article

popular articles