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The "crushed open pelvis" in children.
R Mosheiff1, A Suchar, S Porat
1Orthopedic Surgery Department, Hadassah-Hebrew University Medical School, Jerusalem, Israel.
Injury
|November 24, 1999
Summary
Open pelvic fractures in children, often from vehicle accidents, have a high mortality rate and frequent complications like sepsis. Aggressive surgical intervention and multidisciplinary care are crucial for better outcomes.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
- Reconstructive Surgery
Background:
- Open pelvic fractures in children are rare but severe injuries.
- High rates of vertical instability and associated injuries are common.
- Mortality and complication rates remain significant challenges in pediatric trauma care.
Purpose of the Study:
- To review the outcomes of pediatric open pelvic fractures.
- To identify common injury mechanisms and complications.
- To evaluate the effectiveness of current treatment strategies.
Main Methods:
- Retrospective analysis of 15 pediatric patients with open pelvic fractures.
- Review of medical records, radiographs, and CT scans.
- Minimum two-year follow-up for survivors.
Main Results:
- 20% mortality rate (3 out of 15 patients).
- Sepsis and deep infections were the most frequent complications.
- Auto-pedestrian collisions, particularly run-over incidents involving heavy vehicles, were the primary cause (93%).
- Ten fractures were vertically unstable.
Conclusions:
- Open pelvic fractures in children carry a high risk of mortality and morbidity.
- Aggressive management, including surgical irrigation, debridement, antibiotics, ostomies, and fracture fixation (considering open reduction and internal fixation), is essential.
- Multidisciplinary team coordination is critical for optimizing patient outcomes.