Anatomic, diagnostic and management challenges in paediatric pelvic injuries: a review

Area of Science:

• Orthopedics
• Pediatric Traumatology

Background:

• Pelvic injuries in children are uncommon, affecting 1 in 100,000 annually in the UK.
• Approximately 10% of pediatric pelvic injuries are classified as unstable.
• Accurate diagnosis and management are crucial for optimal outcomes.

Purpose of the Study:

• To critically review imaging options for acute pediatric pelvic injuries.
• To outline management strategies for different types of pelvic fractures.
• To provide guidance on surgical interventions for unstable fractures.

Main Methods:

• A comprehensive literature review was conducted.
• Diagnostic benefits of Judet views and limited computed tomography scans were assessed.
• Treatment algorithms for pelvic fractures based on stability and displacement were analyzed.

Main Results:

• Clinical examination alone can rule out the need for imaging in stable pediatric pelvic injuries.
• Judet views and limited computed tomography scans offer diagnostic value in specific acute pelvic injury cases.
• Fractures with displacement >1 cm require reduction and stabilization.
• Rotationally unstable fractures benefit from closed reduction and external fixation.
• Rotationally and vertically unstable fractures may require open or closed reduction with internal fixation.

Conclusions:

• Imaging is not always necessary for stable pediatric pelvic injuries.
• Judet views and limited CT scans are valuable diagnostic tools.
• Surgical intervention, including fixation, is indicated for unstable and displaced pelvic fractures in children.