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Published on: November 8, 2024
Clinical analysis of 60 children with pelvic fracture and associated injuries: an observational study
Insights
Early diagnosis and treatment of pediatric pelvic fractures with associated injuries lead to better outcomes. Prompt intervention, including reduction and fixation, is crucial for improving clinical efficacy in children.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
- Emergency Medicine
Background:
- Pelvic fractures in children often result from high-energy trauma.
- These fractures frequently involve injuries to other tissues and organs.
- Effective management strategies for pediatric pelvic fractures are essential.
Purpose of the Study:
- To investigate the clinical effectiveness of early diagnosis and treatment for pelvic fractures and associated injuries in children.
- To evaluate the outcomes of a comprehensive management approach.
Main Methods:
- Retrospective analysis of 60 children (ages 2-15) with pelvic fractures and associated injuries.
- Fracture classification using the Torode and Zieg system.
- All patients received early diagnosis, anti-shock measures, treatment of associated injuries, and early fracture reduction and fixation.
Main Results:
- Common causes included traffic accidents, falls from height, and crushing injuries.
- Associated injuries were frequent, including hemorrhagic shock, traumatic brain injury, and pelvic large vessel injuries.
- The overall excellent and good outcome rate was 92.5% (50/54) after an average follow-up of 48 months.
Conclusions:
- Early diagnosis, reduction, and fixation of pelvic fractures in children are effective.
- Timely treatment of associated injuries significantly improves clinical outcomes.
- This management approach is recommended for clinical promotion in pediatric trauma care.
Background:
The injury mechanism of a pelvic fracture is primarily high-energy injury, and it is easily combined with injuries to other tissues and organs. This study aimed to investigate the clinical effectiveness of early diagnosis and treatment of pelvic fractures and associated injuries in children.
Methods:
The diagnosis and treatment of 60 children with pelvic fractures and associated injuries who were admitted to our hospital from January 2005 to December 2016 were retrospectively analyzed. Among these patients, 36 were male, and 24 were female. The patients' ages ranged within 2-15 years, with an average of 7.6 years old. The pelvic fractures were classified based on the Torode and Zieg classification; among the patients, 12 had type I, 16 had type II, 20 had type III, and 12 had type IV. All patients received early diagnosis, immediate anti-shock measures, aggressive treatment of associated injuries, and early reduction and fixation of the pelvic fractures after admission.
Results:
Of the 60 patients, 28 had injuries caused by traffic accidents, 26 had injuries caused by falling from high places, and 16 had injuries caused by compressing or crushing. Eight patients had unilateral pubic bone fracture or pubic symphysis separation that involved posterior pelvic fracture or sacroiliac joint separation, and two had fractures that affected the anterior ring or acetabulum. Moreover, 26 patients had hemorrhagic shock, 18 had traumatic brain injury, 14 had fractures at other sites, 8 had pelvic large vessel injuries, 8 had ipsilateral femoral and proximal femoral fractures, 8 had retroperitoneal hematoma, 8 had urinary system injury, 6 had perineal laceration and vaginal trauma, 6 had spinal cord injury, 4 had intestinal injuries, 4 had soft tissue contusions, and 4 had sacral nerve injury. During the follow-up (average: 48 months), six children died. The evaluation results of the curative effect were excellent in 32 children, good in 18, and poor in 4; the 'excellent' and 'good' rate was 92.5% (50/54).
Conclusion:
Early diagnosis, reduction, and fixation and timely treatment of associated injuries might achieve better clinical efficacy and are worthy of clinical promotion.
Key Words:
Associated Injuries, Childhood, Diagnosis, Fracture, Pelvic, Treatment.
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