Retrospective Analysis Of Traumatic Triradiate Cartilage Injury In Children

Objective:To summarize and analyze the epidemiological characteristics,treatment and corresponding curative effect of triradiate cartilage injury in children after trauma,so as to provide theoretical basis for early diagnosis and improvement of treatment.Methods:Fifteen children with post-traumatic triradiate cartilage injury treated in the Chongqing Medical University Affiliated Children’s Hospital from January 2010 to December 2017 were collected retrospectively through medical records systems,picture archiving and telephone follow-up.The triradiate cartilage injury was classified according to Bucholz classification,and the final curative effect was evaluated with Harris Hip Score table and imaging examination during follow-up.Finally,a comprehensive analysis was made by reviewing the cases in the literature combined with the cases in our hospital.Results:A total of 191 children with pelvic fractures were treated in our hospital from January 2010 to December 2017,including 24 cases ofacetabular fractures accounting for 12.6% of pelvic fractures and 15 cases(18 hips)of triradiate cartilage injuries accounting for 62.5% of acetabular fractures.Among the 15 cases,there were 10 males and 5females,ranging from 1 year 4 months to 9 years 8 months,with a mean age of 5 years 6 months.The main type of injury was type II.There were 1hip with type I injury,9 hips with type II injury,2 hips with type IV injury,1 hip with type V injury and 5 hips with type VI injury.All the children received conservative treatment with a mean follow-up time of 5 years.Among the 12 cases with complete follow-up,bone bridge was found in or around the triradiate cartilage in 8 cases,early fusion of triradiate cartilage occured in 5 cases,3 cases had hip dysplasia,4 cases had subluxation of the femoral head,and HHS was excellent in 8 cases and good in 4 cases.Conclusion:The early diagnosis of triradiate cartilage injury is still a difficult problem.Conservative treatment is often the first choice when there is no clear surgical indication for acetabular fracture.The overall prognosis of acetabular fractures involving triradiate cartilage is poor.Age,location and degree of injury are important factors affecting the prognosis.The formation of bone bridge in triradiate cartilage often indicates the possibility of early closure.The younger the age,the greater the impact on acetabular development,which may lead to serious complications of post-traumatic acetabular dysplasia and subluxation of the femoral head.