BACKGROUND Calcifications along ventricular catheters have been associated with shunt fractures although it is unknown whether their development predicts whether and when the shunts will fracture. OBJECTIVE To determine whether extracranial calcifications found on a radiographic shunt series predicts whether a patient will experience a shunt catheter fracture or complication. MATERIALS AND METHODS A retrospective review was performed of pediatric patients with a ventricular shunt placed before 18 years of age and radiographic shunt series. Two thousand, six hundred and thirty shunt series in 523 patients (301 male) were reviewed to identify the development of calcifications around the catheter and fracture. Fifty-one patients were excluded for preexisting calcifications with shunt fracture. (48) Absence of shunt (2) or age (1). Analysis included descriptive statistics, odds ratio and chi-square test results. RESULTS Four hundred seventy-two patients were included. Of the 59 shunts in 58 patients that developed calcifications, 23 went on to fracture (39%). Forty shunts without calcification in 37 patients developed fractures. There is a significant positive association between calcification and fracture (Χ2=39.1, P<0.01). It is 6.12 times more likely that a fractured shunt had calcifications compared to a non-fractured shunt having calcifications. Calcifications appeared within an average of 9 years, 10 months (range: 4-14 years) after shunt insertion. Shunt fractures occurred within an average of 5 years, 2 months (range: 6 months-9 years) after the appearance of calcifications with a median patient age of 14.6 years. Nearly all fractures were at or adjacent to the calcifications, most commonly in the neck (17/23; 73.9%). CONCLUSION Shunt calcification represents a significant risk for catheter fracture in the pediatric population. Early intervention or closer interval follow-up may be indicated in those found to have calcifications.

中文翻译：

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心室分流导管钙化与分流骨折发展之间的关联。

背景技术沿室导管的钙化已与分流骨折相关，尽管尚不清楚其发展是否预示分流是否破裂以及何时破裂。目的要确定在放射照相分流术系列中发现的颅外钙化是否可以预测患者是否会发生分流术导管破裂或并发症。材料与方法回顾性研究了18岁以前放有心室分流术的X线影像学分流术的儿科患者。对523例患者（301例男性）中的2,630个分流器进行了回顾，以确定导管周围钙化的发展和骨折。51名因钙化合并分流骨折而被排除在外的患者。（48）没有分流（2）或年龄（1）。分析包括描述性统计，比值比和卡方检验结果。结果纳入472例患者。在58例发生钙化的患者中，有59例分流，其中23例继续骨折（39％）。37名患者中有40例未钙化的分流发生了骨折。钙化与骨折之间存在显着的正相关（Χ2= 39.1，P <0.01）。断裂的分流器有钙化的可能性是非断裂的分流器有钙化的可能性的6.12倍。分流器插入后平均9年10个月（范围：4-14年）内出现钙化。在钙化出现后平均5年零2个月（范围：6个月至9年）内发生分流骨折，患者中位年龄为14.6岁。几乎所有骨折都位于钙化处或钙化附近，最常见于颈部（17/23； 73.9％）。结论分流钙化代表小儿人群导管断裂的重大危险。发现有钙化的患者可能需要早期干预或间隔时间更短的随访。