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[Pediatric pelvic trauma].

A Gänsslen1, A Weinberg2

  • 1Klinik für Unfallchirurgie, Orthopädie und Handchirurgie, Klinikum Wolfsburg, Sauerbruchstr. 7, 38440, Wolfsburg, Deutschland. dr.gaensslen@gmx.de.

Der Unfallchirurg
|April 25, 2020
PubMed
Summary
This summary is machine-generated.

Rare pelvic girdle injuries in children, often from high-energy trauma, require careful management. Long-term monitoring is crucial for outcomes, especially with acetabular injuries.

Keywords:
AcetabulumAftercareFracture fixationPelvic girdleRadiography

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Area of Science:

  • Pediatric Orthopedics
  • Trauma Surgery
  • Pediatric Radiology

Background:

  • Pelvic girdle injuries in children are rare but severe, frequently resulting from high-energy trauma.
  • These injuries present unique anatomical challenges and are associated with a significant rate of accompanying injuries and up to 6% mortality.
  • Established adult treatment standards are adapted for pediatric emergencies, with a trend towards conservative management and specialized pediatric implants.

Purpose of the Study:

  • To review the management and long-term consequences of rare pelvic girdle injuries in children.
  • To highlight the diagnostic challenges, particularly for acetabular fractures, and their prognostic indicators.
  • To emphasize the importance of vigilant follow-up for preventing post-traumatic complications.

Main Methods:

  • Review of clinical and radiological outcomes in pediatric patients with pelvic girdle injuries.
  • Application of the Salter-Harris classification for prognostic assessment of acetabular injuries.
  • Analysis of treatment strategies, including conservative management and surgical interventions like open reduction and internal fixation.

Main Results:

  • Most acetabular injuries in children can be managed conservatively.
  • Significant displacement or intra-articular involvement necessitates surgical intervention (open reduction and internal fixation).
  • A correlation between clinical and radiological results is observed, underscoring the importance of accurate assessment.

Conclusions:

  • Long-term consequences, especially after unstable pelvic ring injuries, must be considered.
  • Acetabular injuries are prone to being overlooked due to radiological assessment difficulties; frequent follow-up is essential.
  • The Salter-Harris classification is a useful prognostic tool, and vigilant monitoring up to skeletal maturity can prevent overlooked post-traumatic acetabular dysplasia.