title: Associated Injuries in Skeletally Immature Children with Pelvic Fractures.
abstract: BACKGROUND
  Pediatric pelvic fractures are rare injuries resulting from high-energy mechanisms that warrant an extensive work-up for associated injuries.
  
  
  OBJECTIVE
  We performed a retrospective study to review concomitant injuries in children who suffered a pelvic fracture and have an open triradiate cartilage.
  
  
  METHODS
  Using a database, pediatric pelvic fractures presenting to the authors' institution were extracted. Radiographs and computed tomography scans were reviewed, ensuring that triradiate cartilages were not fused and the pelvic injuries were classified using the Modified Torode Classification. Epidemiologic data extracted included Glasgow Coma Scale (GCS), Injury Severity Score (ISS), and Abbreviated Injury Score (AIS).
  
  
  RESULTS
  Sixty patients met the inclusion criteria, and their average age was 8.3 years (range 2-14 years). There were no mortalities. The most common mechanism of injury was a vehicle striking a pedestrian. There were no significant correlations between GCS, ISS, and AIS. All 60 children (100%) suffered extremity injuries. Nineteen patients required surgical orthopedic intervention, and 6 required operative stabilization of the pelvis. Patients who were struck by a motor vehicle were more likely to have multiple pelvic fractures (p < 0.05). Patients with multiple pelvic fractures were more likely to require orthopaedic surgical intervention and require a blood transfusion (p < 0.05). Patients who had type III-B or IV fractures were more likely to require a transfusion than patients with III-A fracture (p < 0.05).
  
  
  CONCLUSIONS
  Patients sustaining fractures to an immature pelvis are likely to have additional injuries, which may be fatal or disabling if not diagnosed in a timely manner.
authors.affiliation: Department of Orthopaedic Surgery, Rutgers University - New Jersey Medical School, Newark, New Jersey.
authors.forename: M Kareem
authors.initials: MK
authors.lastname: Shaath
authors.affiliation: Department of Orthopaedic Surgery, Rutgers University - New Jersey Medical School, Newark, New Jersey.
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Koury
authors.affiliation: Department of Orthopaedic Surgery, Rutgers University - New Jersey Medical School, Newark, New Jersey.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Gibson
authors.affiliation: Department of Orthopaedic Surgery, Rutgers University - New Jersey Medical School, Newark, New Jersey.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Adams
authors.affiliation: Department of Orthopaedic Surgery, Rutgers University - New Jersey Medical School, Newark, New Jersey.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Sirkin
authors.affiliation: Department of Orthopaedic Surgery, Rutgers University - New Jersey Medical School, Newark, New Jersey.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Reilly
mesh_terms: D000293:Adolescent; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002356:Cartilage / Q000293:injuries; D002648:Child; D002675:Child, Preschool; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009104:Multiple Trauma / Q000453:epidemiology*; D010384:Pelvic Bones / Q000293:injuries*; D012189:Retrospective Studies
keywords: injury burden; multitrauma; orthopedics; pediatric pelvic fractures; pediatrics