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Open pelvic fracture with vaginal laceration and diaphragmatic rupture in a child
S D Heinrich1, C H Sharps, J A Cardea
1Department of Surgery, Medical College of Virginia, Richmond.
Insights
This case report highlights a rare pediatric pelvic fracture with diaphragmatic rupture. Pelvic external fixation is an effective treatment for unstable pediatric pelvic fractures, especially in multi-system injuries.
Area of Science:
- Trauma Surgery
- Pediatric Orthopedics
- Thoracic Surgery
Background:
- Pelvic fractures in children differ significantly from adult fractures.
- Diaphragmatic rupture is a rare but serious complication associated with pelvic fractures.
Observation:
- A 4-year-old child presented with an unstable open pelvic fracture and diaphragmatic rupture.
- This case underscores the strong correlation between pelvic fractures and diaphragmatic injuries.
Findings:
- Pelvic external fixation offers a faster and less morbid surgical option for unstable pediatric pelvic fractures compared to open reduction.
- This technique is particularly beneficial for pediatric patients with multi-system trauma.
Implications:
- Early and appropriate management of pediatric pelvic fractures is crucial to prevent long-term complications.
- Pelvic external fixation serves as an excellent alternative for acute treatment in pediatric multi-system trauma.
- Staged secondary open reduction can be considered if initial closed reduction is inadequate.
Abstract:
A case report of a 4-year-old child who sustained an unstable open pelvic fracture with a diaphragmatic rupture is presented. A strong correlation exists between rupture of the diaphragm and pelvic fractures. We note the difference between pediatric and adult pelvic fractures, and discuss late complications unique to the child with a pelvic fracture. Pelvic external fixation is faster and less morbid than other surgical treatments for unstable pelvic fractures, and therefore provides an excellent alternative to pelvic open reduction in the acute treatment of pediatric patients with multi-system injuries. If fracture reduction is incomplete following initial closed manipulation, a staged secondary open reduction can then be performed.