Pediatric Pelvic Fractures and Differences Compared With the Adult Population
Carolina de la Calva1, Nadia Jover1, Jaime Alonso1
1From the Departments of Orthopaedic Surgery.
Insights
Pediatric pelvic fractures, though rare, often result from high-energy trauma. Associated injuries are common, necessitating multidisciplinary care in pediatric trauma centers for optimal outcomes.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
- Pediatric Radiology
Background:
- Pelvic fractures in children are uncommon but possess unique characteristics due to skeletal immaturity.
- Understanding these differences is crucial for effective diagnosis and management.
Purpose of the Study:
- To analyze the characteristics, injury mechanisms, associated injuries, and treatment outcomes of pelvic fractures in skeletally immature patients.
- To highlight the specific patterns and management considerations for pediatric pelvic fractures.
Main Methods:
- Retrospective chart review of pediatric pelvic fractures treated over a 20-year period (1993-2013).
- Inclusion of skeletally immature patients with pelvic fractures.
- Analysis of injury mechanisms, fracture classifications (Tile, Torode and Zieg), associated injuries, treatment modalities, and outcomes.
Main Results:
- Eighty-one pediatric pelvic fractures were identified, with a mean age of 9.98 years; traffic accidents were the primary cause.
- Tile type A2 and Torode and Zieg type IIIA were the most frequent classifications.
- Associated injuries (e.g., other fractures, head trauma) were present in 77.8%; 8.64% mortality rate observed.
Conclusions:
- Pediatric pelvic fractures result from high-energy trauma, with distinct patterns compared to adults.
- High incidence of associated injuries necessitates comprehensive evaluation and management.
- Multidisciplinary care in specialized pediatric trauma centers is essential for optimal patient outcomes.
Introduction:
Although pelvic fractures in children are rare, because of anatomical differences between an adult's skeleton and a child's skeleton, these lesions in the pediatric population have specific characteristics that need to be borne in mind when dealing with them.
Materials And Methods:
A retrospective chart review was performed on the pelvic fractures in skeletally immature patients treated in our hospital in the last 20 years.
Results:
Eighty-one pelvic fractures in children were treated between 1993 and 2013. The mean age was 9.98 years, with 61.7%(50/81) boys and 38.2% (31/81) girls. A traffic accident was the main injury mechanism (74%, 60/81), and height fall was in second place (16%, 13/81). Following Tile pelvic fracture classification, type A2 was the most frequent (58.04%, 47/81); and following Torode and Zieg classification, type IIIA (45.68%, 37/81).Associated injuries were present in 77.8% (63/81) of the patients; fractures of other bones and head trauma were the most frequent. An acetabular fracture was present in 13.5% (11/81) of the patients.Nonsurgical treatment was chosen for all the pelvic fractures except in 4 patients, which required surgical management for their pelvic injuries. Blood transfusion was required in 32% (26/81) of the patients, and arterial embolization was not needed in any case. Furthermore, 11.1% (9/81) required a stay in the pediatric care unit, and the death rate was 8.64% (7/81).The mean length of hospital stay was 12.4 days.
Conclusions:
Because of the specific characteristics of pelvic fractures in children, fracture patterns are less severe than those of adults, but the injury mechanisms are high-energy traumas. The rate of associated injuries is very high, and a multidisciplinary management in pediatric trauma centers is needed to treat these patients.
Related Concept Videos
02:04Conservation of Small Populations
01:25What is Population Genetics?
00:57Population Growth
01:26Muscles of the Pelvic Floor and Perineum
Perineal Layer
The perineum is a diamond-shaped area below the pelvic diaphragm, divided into an anterior urogenital triangle that contains the external genitals and a posterior anal triangle housing the anus. The urogenital...
00:30What are Populations and Communities?
02:24Comparative Excretory Systems