A prospective evaluation of the clinical presentation of pediatric pelvic fractures.
BACKGROUND
We sought to describe pediatric, blunt trauma patients with pelvic fracture (PF) and to evaluate pelvis examination sensitivity and specificity.


METHODS
We conducted a prospective study of blunt trauma patients at a Level I pediatric trauma center. A pediatric emergency medicine physician attempted to diagnose a PF, solely on the basis of the history and pelvis examination. Patients with blunt trauma but no pelvic fracture (NPF) were used as controls.


RESULTS
We enrolled 140 patients (16 PF, 124 NPF), and no significant differences were found regarding median age, gender, injury mechanism, acuity, and medical outcome. Approximately 25% of PF patients had iliac-wing fractures; 37%, single pelvic ring; 25%, double pelvic ring; and 13%, acetabular fractures. Eleven patients with PF had an abnormal pelvis examination (69% sensitivity), compared with six NPF patients (95% specificity, negative predictive value 0.91).


CONCLUSIONS
Pediatric patients with PF have low mortality and few complex fractures. The pelvis examination appears to have both high specificity and negative predictive value.
Junkins
E P
EP
Division of Pediatric Emergency Medicine, Primary Children's Medical Center, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah 84113, USA. ed.junkins@hsc.utah.edu
Nelson
D S
DS
Carroll
K L
KL
Hansen
K
K
Furnival
R A
RA
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D050723:Fractures, Bone / Q000145:classification / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D008297:Male; D008487:Medical History Taking; D010384:Pelvic Bones / Q000293:injuries*; D010808:Physical Examination; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014193:Trauma Centers; D014949:Wounds, Nonpenetrating / Q000145:classification / Q000175:diagnosis*