title: SURGICAL TREATMENT OF UNSTABLE PELVIC RING FRACTURE IN SKELETALLY IMMATURE PATIENTS.
abstract: OBJECTIVE
  To present the outcomes from definitive surgical treatment for unstable fractures of the pelvic ring in children undergoing surgical reduction and stabilization.
  
  
  METHODS
  We studied 10 patients with immature skeletons who suffered unstable fractures of the pelvic ring and were treated between March 2004 and January 2008. The study was retrospective, based on clinical and radiographic evaluations.
  
  
  RESULTS
  The mean age at the time of the trauma was 8.8 years (2 to 13 years). Seven patients were female and three was male. There were eight cases of trauma caused by being run over, and one case each of a motorcycle accident and falling from a height. Five patients had other associated injuries such as fractures of the clavicle, femoral diaphysis, proximal humerus, lower leg bones, olecranon and bladder injury. All the patients evaluated showed an excellent clinical outcome. The pelvic asymmetry before surgery ranged from 0.7 to 2.9 cm (mean 1.45 cm), and dropped to values between 0.2 and 0.9 cm (mean 0.39 cm) after reduction. In no case was any change observed in pelvic asymmetry measured in the immediate postoperative period and at the end of follow-up.
  
  
  CONCLUSIONS
  Pelvic ring fractures in skeletally immature patients are rare and surgical treatment is unusual. Several authors have questioned conservative treatment because of the complications encountered. Bone remodeling does not seem enough to cause an improvement in pelvic asymmetry, and this justifies the choice of surgical treatment for reduction and correction of pelvic ring deformities.
authors.affiliation: Head of the Orthopedics and Traumatology Service, National Institute of Traumatology and Orthopedics (INTO/MS).
authors.forename: Joao Antonio Matheus
authors.initials: JA
authors.lastname: Guimarães
authors.affiliation: Resident Physician in the National Institute of Traumatology and Orthopedics (INTO/MS).
authors.forename: Ricardo
authors.initials: R
authors.lastname: de Souza Portes Meirelles
authors.affiliation: Resident Physician in the National Institute of Traumatology and Orthopedics (INTO/MS).
authors.forename: Luiz Augusto Peçanha Tavares
authors.initials: LA
authors.lastname: Júnior
authors.affiliation: Physician in the Orthopedic Trauma Surgery Center, National Institute of Traumatology and Orthopedics (INTO/MS).
authors.forename: Flávio
authors.initials: F
authors.lastname: Goldsztajn
authors.affiliation: Physician in the Orthopedic Trauma Surgery Center, National Institute of Traumatology and Orthopedics (INTO/MS).
authors.forename: Tito
authors.initials: T
authors.lastname: Rocha
authors.affiliation: Head of the Children and Adolescents' Surgery Center, National Institute of Traumatology and Orthopedics (INTO/MS).
authors.forename: Pedro Henrique Barros
authors.initials: PH
authors.lastname: Mendes
keywords: Child; Fracture Fixation; Pelvis