Treatment of acetabular fractures in pediatric patients

  • Authors: Useinov A.V.1, Keshishyan R.А.2, Petrov M.А.3, Manzhos P.I.4, Mansurova S.U.5
  • Affiliations:
    1. I.M. Sechenov First Moscow State Medical University (Sechenov University)
    2. Federal State Budgetary Educational Institution of the Peoples' Friendship University of Russia, Federal State Budgetary Educational Institution of the Russian Federation "Russian Medical Academy of Continuing Professional Education" of the Ministry of Health of the Russian Federation, GBUZ "NPC Special Medical Care for Children of the DZM".
    3. Ilyinskaya Hospital JSC
    4. Federal State Autonomous Educational Institution of Higher Education "Russian Peoples' Friendship University"
    5. Federal State Educational Institution of Higher Education "Peoples' Friendship University of Russia"
  • Section: REVIEWS
  • Submitted: 26.09.2024
  • Accepted: 24.03.2025
  • Published: 22.04.2025
  • URL: https://jps-nmp.ru/jour/article/view/834
  • DOI: https://doi.org/10.17816/ps834
  • ID: 834


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Abstract

Introduction. In the structure of pelvic injuries in children, acetabulum fractures occupy 6-17% and occur mainly among adolescents due to age-related ossification of bone tissue and loss of flexibility. Acetabulum fractures are the result of high–energy trauma - traffic accidents, falling from a great height, sports injury and other violence. The basis for the diagnosis of acetabulum fractures in children is an examination using the AES algorithm, an X-ray examination using Judet. At the same time, the high efficiency of CT examination is noted, and a number of authors suggest it as the main method for diagnosing acetabulum injuries in children.

Aim. To analyze and present modern orthopedic approaches to the treatment of acute acetabulum fractures in children.

Materials and methods. The current literature indexed in the databases Scopus, Google Scholar, Embase, MEDLINE, etc. was studied.

Discussion. It has been established that there are two main fields for discussion in the treatment section: the first is about the effectiveness of conservative treatment; the second is about the choice of surgical access to the acetabulum. It has been established that the conservative approach is accompanied by a high risk of osteoarthritis, thrombosis, formation of pressure sores, etc. The surgical method requires timely resuscitation (within 14 days) and reposition before the formation of a callus. In case of a fracture with dislocation, to prevent Perthes' disease, it is necessary to correct the dislocation within the first 6 hours after the injury. It has been established that the best guideline in choosing the tactics of surgical treatment of children with acetabulum injuries is the AO classification (1992). According to it, in case of fractures of the anterior wall, the best access will be AIP (anterior intrapelvic approach, anterior intrapelvic access), the posterior wall KL (Kocher-Langenbeck), and in case of fracture of both – at the discretion of the pediatric surgeon.

Conclusion. There is still uncertainty about the advantages and disadvantages of conservative treatment. Also, the choice of surgical access, on which the body's reaction to the intervention and further recovery of the child will depend, directly depends on the skill of the pediatric surgeon. The quality of postoperative recovery of the child's body also depends on the qualification of the doctor. It is necessary to constantly improve the skills of orthopedic traumatologists and pediatric surgeons regarding the methods of treating fractures of the acetabulum and pelvic bones in general.

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About the authors

Andrey V. Useinov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: med.useinov@gmail.com
ORCID iD: 0000-0002-3426-0682

6th year student 

Россия, 119048, Moscow, Trubetskaya str., 8, bld. 2

Razmik А. Keshishyan

Federal State Budgetary Educational Institution of the Peoples' Friendship University of Russia, Federal State Budgetary Educational Institution of the Russian Federation "Russian Medical Academy of Continuing Professional Education" of the Ministry of Health of the Russian Federation, GBUZ "NPC Special Medical Care for Children of the DZM".

Email: razmik_k@mail.ru
ORCID iD: 0000-0003-3686-3708

d.m.s

Россия, 6 Miklukho-Maklaya str., Moscow, 117198

Mikhail А. Petrov

Ilyinskaya Hospital JSC

Email: m.petrov@me.com
ORCID iD: 0000-0003-4383-2707

MD, PhD, Head of the Pediatric Traumatology and Orthopedics Service

Россия, 143421, Moscow region, Krasnogorsk city district, Glukhovo village, Rublevskoe predmestye str., 2, building 2

Petr I. Manzhos

Federal State Autonomous Educational Institution of Higher Education "Russian Peoples' Friendship University"

Email: fake@neicon.ru
ORCID iD: 0000-0003-1179-921X

PhD

Россия, 117198, Moscow, st. Miklouho-Maklaya, 6

Saodat U. Mansurova

Federal State Educational Institution of Higher Education "Peoples' Friendship University of Russia"

Email: saodat.2002@mail.ru
ORCID iD: 0009-0009-0061-8605

6th year student 

Россия, 6 Miklukho-Maklaya str., Moscow, 117198

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Copyright (c) Useinov A.V., Keshishyan R.А., Petrov M.А., Manzhos P.I., Mansurova S.U.

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