Pediatric acetabular fractures are rare, accounting for only a small percent of pelvic injuries in children. This is a case of a 12-year-old healthy male who sustained a displaced, right posterior acetabular wall fracture following a ground-level fall. It was ultimately determined to be treated through operative management. Intraoperatively, it was noted that the displaced fragment had become trapped posterior to the piriformis muscle. This prompted the surgical release of the piriformis to mobilize the fragment. Afterward, a quarter tubular plate serving as a buttress and multiple cortical screws were placed to secure the fracture. An additional cortical screw and washer were placed for further compression and rotational stabilization. The piriformis was then repaired. The patient was made nonweight bearing for 6 weeks and seen at routine postoperative visits. At 10 weeks postoperatively, the patient had no complaints of pain or difficulty with ambulation and tolerated full range of motion within his right hip. The patient did not return for follow-up, but the mother was contacted at 1 year postoperatively, and she denied any gait or hip range of motion abnormalities within the patient. Unfortunately, no further follow-up was successfully obtained. While most pediatric pelvic injuries can be treated nonoperatively, it has been shown that nonoperative treatment has increased risk of long-term complications. Therefore, surgical consideration remains important as it presents an opportunity for fewer long-term sequelae.
Case Rep Orthop Res 2022;5:38–44

中文翻译：

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病例报告：小儿髋臼后壁梨状肌卡压

小儿髋臼骨折很少见，仅占儿童骨盆损伤的一小部分。这是一个 12 岁健康男性的病例，他在地面跌倒后出现移位的右髋臼后壁骨折。最终决定通过手术治疗。术中发现移位的碎片被卡在梨状肌后方。这促使通过手术释放梨状肌来移动碎片。之后，放置一个用作支撑的四分之一管状板和多个皮质螺钉以固定骨折。放置一个额外的皮质螺钉和垫圈以进一步压缩和旋转稳定。然后修复梨状肌。患者在 6 周内停止负重，并在术后常规就诊中进行观察。术后 10 周，患者没有疼痛或行走困难的主诉，并且能够耐受右髋的全范围运动。患者没有返回随访，但在术后 1 年联系了母亲，她否认患者有任何步态或髋关节活动度异常。不幸的是，没有成功获得进一步的跟进。虽然大多数儿科骨盆损伤可以非手术治疗，但已表明非手术治疗会增加长期并发症的风险。因此，手术考虑仍然很重要，因为它提供了减少长期后遗症的机会。患者没有疼痛或行走困难的抱怨，并且可以忍受右髋的全范围运动。患者没有返回随访，但在术后 1 年联系了母亲，她否认患者有任何步态或髋关节活动度异常。不幸的是，没有成功获得进一步的跟进。虽然大多数儿科骨盆损伤可以非手术治疗，但已表明非手术治疗会增加长期并发症的风险。因此，手术考虑仍然很重要，因为它提供了减少长期后遗症的机会。患者没有疼痛或行走困难的抱怨，并且可以忍受右髋的全范围运动。患者没有返回随访，但在术后 1 年联系了母亲，她否认患者有任何步态或髋关节活动度异常。不幸的是，没有成功获得进一步的跟进。虽然大多数儿科骨盆损伤可以非手术治疗，但已表明非手术治疗会增加长期并发症的风险。因此，手术考虑仍然很重要，因为它提供了减少长期后遗症的机会。她否认患者有任何步态或髋关节活动范围异常。不幸的是，没有成功获得进一步的跟进。虽然大多数儿科骨盆损伤可以非手术治疗，但已表明非手术治疗会增加长期并发症的风险。因此，手术考虑仍然很重要，因为它提供了减少长期后遗症的机会。她否认患者有任何步态或髋关节活动范围异常。不幸的是，没有成功获得进一步的跟进。虽然大多数儿科骨盆损伤可以非手术治疗，但已表明非手术治疗会增加长期并发症的风险。因此，手术考虑仍然很重要，因为它提供了减少长期后遗症的机会。
案例代表 Orthop Res 2022；5:38–44