[Pediatric pelvic trauma]

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.