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Comminuted pelvic ring disruption in toddlers: management of a rare injury
R J Stiletto1, M Baacke, L Gotzen
1Department of Trauma Surgery, Philipps-University Marburg, Germany.
Insights
Pediatric pelvic fractures are rare, but CT scans are crucial for diagnosis and surgical planning in toddlers. Timely removal of fixation hardware prevents growth disturbances, necessitating long-term follow-up.
Area of Science:
- Orthopedic surgery
- Pediatric traumatology
- Radiology
Background:
- Pediatric pelvic fractures are uncommon injuries.
- This study presents the clinical management, classification, and operative treatment of pelvic fractures in two toddlers (1-3 years old).
Observation:
- Computed tomography (CT) is the most reliable diagnostic tool for assessing fracture morphology in pediatric pelvic fractures.
- CT findings enable precise classification and surgical planning.
Findings:
- Surgical treatment utilized AO instrumentation for small fragments with standard adult surgical approaches.
- Postoperative management requires adaptation to pediatric physiology.
- Early removal of osteosynthesis material is vital to prevent pelvic epiphysiodesis.
Implications:
- Long-term follow-up is essential to detect late sequelae until skeletal maturity.
- This approach ensures optimal outcomes for pediatric pelvic fracture patients.
- Adherence to specialized management protocols is critical for preventing complications.
Abstract:
Pediatric pelvic fractures are rare injuries. The clinical management, classification, and operative treatment of this type of injury was presented in two toddlers ranging in age from 1 to 3 years. The CT examination proved to be the most reliable diagnostic tool for the assessment of the fracture morphology. The findings of the CT examination provide the possibility for an exact classification and operative planning. The surgical treatment was performed with the AO instrumentation for small fragments by using the approved standard approaches of adult surgery. The postoperative management has to be adapted to the physiology of the children. It is important to remove the osteosynthesis material in due time to avoid the risk of epiphysiodesis at the pelvis. To detect late sequelae of the trauma, follow-up should be performed regularly until growth is completed.