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Frakturen der Brust- und Lendenwirbelsäule im Wachstumsalter

Fractures of the thoracic and lumbar spine in children and adolescents

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Zusammenfassung

Hintergrund

Thorakale und lumbale Wirbelsäulenfrakturen im Wachstumsalter machen nur 1,5–2,0% aller Frakturen bei Kindern und Jugendlichen aus. Die Behandlung ist meist konservativ. Diese Studie vergleicht die Daten des eigenen Patientenguts mit den Angaben der Literatur.

Material und Methode

In einem Zeitraum von 48 Monaten wurden alle Patienten (n=86) mit Frakturen der Brust- und Lendenwirbelsäule vor Vollendung des 16. Lebensjahres prospektiv erfasst; 67 Patienten konnten nach 3–36 Monaten nachuntersucht werden.

Ergebnisse

Das mittlere Verletzungsalter lag bei 11,9 Jahren. Häufigste Unfallursache waren Sport (53%) und Verkehrsunfälle (28%). Die Frakturklassifikation ergab 94% A-, 2% B- und 4% C-Frakturen. Verletzungsschwerpunkte waren mit 47% die mittlere Brustwirbelsäule und mit 41% der thorakolumbale Übergang. Operativ behandelt wurden 9 Fälle (10,4%). Sekundäre Alignementstörungen nach operativer und konservativer Behandlung kamen nicht vor. Neurologische Defizite (n=2) bildeten sich nur teilweise zurück.

Schlussfolgerungen

Die Mehrzahl der Brust- und Lendenwirbelsäulenfrakturen im Wachstumsalter heilt rasch und folgenlos aus. Instabile B- und C-Frakturen (ausschließlich Folge von Verkehrsunfällen) bedürfen wie im Erwachsenenalter der operativen Stabilisierung.

Abstract

Background

Only 1.5-2% of all fractures in children and adolescents are fractures of the thoracic and lumbar spine. Treatment is most often conservative. This study compares the own experience with the recent literature.

Material and methods

Over a 48 month period all patients with fractures of the thoracic and lumbar spine, younger than 16 years were included prospectively. Of the patients 67 underwent follow-up investigations after 3-36 months.

Results

The average age of the patients was 11.9 years. Sports (53%) and traffic (28%) accidents were most frequent. Fractures most often appeared in the mid-thoracic (47%) and thoracolumbar spine (41%). Operative treatment was performed in 9 cases (10.4%). Secondary loss of alignment was not observed neither after conservative nor operative treatment. Neurological deficits (n=2) did not completely improve.

Conclusions

Most fractures of the thoracic and lumbar spine heal fast and without any sequelae. Unstable fractures of type B and C (exclusively occurring as a result of traffic accidents) need operative stabilization as in adults.

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Authors and Affiliations

  1. Klinik für Unfallchirurgie, Unversitätsklinikum Gießen und Marburg GmbH, Klinikstraße 33, 35392, Gießen, Deutschland

    R. Kraus, C. Heiss, N. Dongowski & R. Schnettler

  2. Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Klinikzentrum Nord, Klinikum Dortmund gGmbH, Dortmund, Deutschland

    J.-P. Stahl

  3. Klinik für Orthopädie und Unfallchirurgie, Kliniken des Main Taunus Kreises, Krankenhaus Hofheim, Hofheim, Deutschland

    U. Horas

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  1. R. Kraus
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  2. J.-P. Stahl
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  3. C. Heiss
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  4. U. Horas
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  5. N. Dongowski
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Correspondence to R. Kraus.

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Kraus, R., Stahl, JP., Heiss, C. et al. Frakturen der Brust- und Lendenwirbelsäule im Wachstumsalter. Unfallchirurg 116, 435–441 (2013). https://doi.org/10.1007/s00113-011-2113-8

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  • DOI: https://doi.org/10.1007/s00113-011-2113-8

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