POSTGRADUATE ORTHOPEDIC INSTRUCTION - IMAGING

Case Presentation

Bibiana Dello Russo,^*Mónica Galeano,^** Florencia D’ Adamo

^*Orthopedics and Traumatology Service

^**Diagnostic Imaging Service

^#Non-Accidental Trauma Care Team

Hospital Nacional de Pediatría “Prof. Dr. Juan P. Garrahan”, Autonomous City of Buenos Aires, Argentina

Case Resolution on page 604.

Non-Accidental Trauma

ABSTRACT

We present the case of an 18-month-old boy with multiple fractures resulting from non-accidental trauma, after being dragged down a flight of stairs by his caregiver. The radiological protocol used in our institution for suspected non-accidental trauma is described, along with the diagnostic process and the orthopedic and social management implemented.

Keywords: Non-accidental trauma; pelvic fracture; hip epiphysiolysis; children.

Level of Evidence: IV

Trauma no accidental

RESUMEN

Se presenta el caso de un niño de 18 meses con múltiples fracturas secundarias a un trauma no accidental, al ser arrastrado por las escaleras, por su cuidadora. Se define el protocolo radiológico utilizado en nuestra institución para los casos de trauma no accidental, su diagnóstico y el tratamiento ortopédico y social.

Palabras clave: Trauma no accidental; fractura de pelvis; epifisiólisis de cadera; niños.

Nivel de Evidencia: IV

INTRODUCTION

An 18-month-old boy was brought unconscious to the clinic by his grandmother, who reported that he had been dragged down the stairs by his caregiver approximately 45 minutes earlier. Bruises were observed on all four limbs and on the lower abdomen, in different stages of evolution. He was treated in the emergency department with suspected non-accidental trauma. After stabilizing the child and given the clinical suspicion, anteroposterior pelvic radiographs were requested. The Radiological Protocol for Children (Table) was applied.

FINDINGS AND INTERPRETATION OF IMAGING STUDIES

Of all the radiographs obtained, the AP pelvic radiograph revealed fractures consistent with polytrauma (Figure 1). A type C pelvic fracture according to the AO classification was observed, along with an avulsion of the iliac wing and a type A fracture within the same classification.1 In the left proximal femoral epiphysis, a type I (transepiphyseal) epiphysiolysis was identified according to the Delbet classification (Figures 2 and 3). ²

REFERENCES

1. Slongo T, Audigé L, Group APC. Fracture and dislocation classification compendium for children - The AO pediatric comprehensive classification of long bone fractures (PCCF). J Orthop Trauma 2007;21(10 Suppl):S135-60. https://doi.org/10.1097/00005131-200711101-00020

2. Delbet P (cited by Colonna PC): Colonna PC. Fracture of the neck of the femur in children. Am J Surg 1929(6):793-797.

M. Galeano ORCID ID: https://orcid.org/0000-0002-3904-3783

F. D’Adamo ORCID ID: https://orcid.org/0009-0006-9700-0999

Received on October 5th, 2024. Accepted after evaluation on December 12th, 2024 • Dr. Bibiana Dello Russo • bibianadellorusso@gmail.com • https://orcid.org/0000-0001-6487-4418

How to cite this article: Dello Russo B, Galeano M, D’Adamo F. Postgraduate Orthopedic Instruction – Imaging. Case Presentation. Rev Asoc Argent Ortop Traumatol 2025;90(6):499-502. https://doi.org/10.15417/issn.1852-7434.2025.90.6.2042

Article Info

Identification: https://doi.org/10.15417/issn.1852-7434.2025.90.6.2042

Published: December, 2025

Conflict of interests: The authors declare no conflicts of interest.

License: This article is under Attribution-NonCommertial-ShareAlike 4.0 International Creative Commons License (CC-BY-NC-SA 4.0).