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Operative intervention of unstable paediatric pelvic fracture: radiological and functional assessment
Mahmoud Fahmy1, Mohamed Ahmed Abdelmoneim2
1Pelvis Fracture and Arthroplasty Unit, Orthopaedic Department, Cairo University, Giza, Egypt. mahmoudfahmy1986@gmail.com.
Insights
Surgical fixation of unstable pediatric pelvic fractures shows promising clinical outcomes and a low complication rate. This study evaluated radiological and functional results in young patients, highlighting the need for systematic injury assessment and stabilization.
Area of Science:
- Orthopedic surgery
- Pediatric trauma care
- Skeletal reconstruction
Background:
- Unstable pediatric pelvic fractures are challenging injuries requiring specialized management.
- Evaluating surgical outcomes in this population is crucial for optimizing treatment strategies.
Purpose of the Study:
- To present new data on the radiological and clinical evaluation of surgically fixed unstable pediatric pelvic fractures.
- To document complications and functional outcomes following surgical intervention in children.
Main Methods:
- Prospective study of 21 pediatric patients (<16 years) with unstable pelvic fractures treated surgically (2012-2017).
- Surgical fixation included external, internal, and Infix system for anterior ring fixation.
- Radiological and functional assessments used the functional independence measure (FIM) and modified Merle d'Aubigne and Postel (MDP) scores.
Main Results:
- Mean patient age was 12.5 years; motorcar accidents were the primary cause.
- Nine patients had Tile's type B, and 12 had Tile's type C injuries.
- All fractures united by 8 weeks, with no pelvic asymmetry or leg length discrepancy at 2-year follow-up. Mean FIM: 122.5, Mean MDP: 16.2.
Conclusions:
- Displaced unstable pelvic fractures in children necessitate systematic evaluation and anterior ± posterior ring stabilization.
- Surgical fixation can achieve favorable clinical outcomes with a low complication rate.
- Further large-scale studies are recommended to support these findings.
Purpose:
The aim of the study was to add to the literature new data regarding the evaluation of surgical fixation of challenging unstable paediatric pelvic fractures, radiologically and clinically besides recording any complications through the follow-up period.
Methods:
Prospective study was conducted at our hospital between 2012 and 2017 where 21 patients less than 16 years with unstable fracture pelvis were surgically fixed. The method of fixation varied between the external percutaneous fixation and internal fixation. The Infix system was used in for anterior ring fixation in some cases. Patients were evaluated radiologically and functionally using the functional independence measure questionnaire (FIM) and the modified Merle d'Aubigne and Postel (MDP) score.
Results:
Twelve males and 9 females were fixed with mean age of 12.5 years. Motorcar accident was the main mode of trauma. Nine patients had fracture pelvis Tile's type B and 12 had Tile's type C injuries. All fractures united by 8 weeks. No patients suffered from pelvic asymmetry or leg length discrepancy at a mean follow-up of 2 years. The mean of FIM was 122.5 and the mean of MDP score was 16.2.
Conclusion:
Displaced unstable pelvic fractures in children need a systematic evaluation of the injury pattern. These serious fractures should be referred for anterior ± posterior ring stabilization. Promising clinical outcomes with surgical fixation can be reached with a low rate of complications. Further large-scale studies should be conducted for the calling literature.
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