Paediatric pelvic ring fractures and associated injuries.
BACKGROUND
Paediatric pelvic fractures have been infrequently reviewed. The study was performed to highlight the unique features of pelvic fractures in children.


METHODS
A 14-year retrospective study was undertaken of all patients treated for a pelvic fracture at our institute.


RESULTS
Thirty-nine children were included. The mean Injury Severity Score (ISS) was 17.1 (range 4-75). Simple ring fractures were the most common type (46%), dominated by pedestrian versus motor vehicle trauma (58.9%). A pelvic fracture was evident on the initial plain radiographs of all 39 children. Further radiographic investigations (12 CTs and 1 MRI) were undertaken in 13 (33%) of the children. Additional posterior ring fractures were identified in 9. A total of 32 children (82%) sustained one or more associated injuries. Head injuries accounted for 25% and orthopaedic/skeletal injuries for 33% of all associated injuries. Fourteen children required a total of 24 acute surgical procedures. Mean out-pateint clinical follow-up was for 27 months (range 3-85). There was one mortality in this series. Eight children (20%) suffered long term sequale.


CONCLUSIONS
Paediatric pelvic fractures differ from their adult counterpart in aetiology, fracture type, and associated injury pattern. They represent a reliable marker for severe trauma. Prospective studies are required to define optimal treatment guidelines, particularly in older children.
Leonard
Michael
M
Department of Pediatric Orthopaedics, Childrens University Hospital, Dublin, Ireland. mikeleonard77@gmail.com
Ibrahim
Mohammed
M
Mckenna
Paul
P
Boran
Sinead
S
McCormack
Damian
D
D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D050723:Fractures, Bone / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D023261:Glasgow Outcome Scale; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D010384:Pelvic Bones / Q000293:injuries*; D011859:Radiography; D012189:Retrospective Studies