Abstract
Introduction The goals of this study were to investigate the association between paediatric flexion-distraction fractures of the lumbar spine and abdominal injuries and to analyse the variety of the abdominal injuries seen with this type of fracture.
Methods A retrospective chart review was performed at three hospitals (British Columbia Children’s Hospital, Vancouver, Canada, Mater Children’s Hospital and Royal Children’s Hospital, Brisbane). All patients under the age of fifteen who had suffered a flexion-distraction fracture were included. Data collected from the chart related to seating position, the use of seat belts and the spinal and abdominal injuries. The time elapsed from presentation to the time of diagnosis of abdominal injury was also recorded.
Results Forty one patients were included. There were 16 male and 25 female patients. All injuries were due to motor vehicle accidents. The average age at the time of accident was 9 years and 8 months. Twenty-two of the forty-one patients (53%) suffered an intra-abdominal injury. Twenty-one of these patients required operative intervention for their abdominal trauma. The spectrum of injuries included small bowel, large bowel, mesenteric and solid organ injuries. Eighteen of the twenty-two patients sustained a small bowel injury.
Discussion Abdominal trauma after flexion-distraction fractures of the lumbar spine is common. Often the abdominal trauma is significant and may require a laparotomy. A high index of suspicion should be maintained for all patients who present to the orthopaedic department with this type of injury.
The abstracts were prepared by Assoc Prof Bruce McPhee. Correspondence should be addressed to him at the Division of Orthopaedics, The University of Queensland, Clinical Sciences Building, Royal Brisbane Hospital, Herston, Brisbane, 4029, Australia.
