[Treatment outcome after complex pelvic trauma in children]

Area of Science:

• Orthopedics
• Pediatric Trauma Surgery
• Radiology

Background:

• Complex pelvic trauma in children is a rare but severe injury.
• Long-term outcomes and functional recovery in pediatric pelvic trauma patients are not well-documented.

Purpose of the Study:

• To evaluate the long-term functional and radiological outcomes of complex pelvic trauma in children.
• To identify factors influencing prognosis and social reintegration in this patient cohort.

Main Methods:

• Retrospective analysis of 21 pediatric patients (up to 14 years) treated for complex pelvic trauma between 1972 and 1994.
• Follow-up of 16 survivors at an average of 8.9 years, assessing pain, micturition, bowel function, and social reintegration.
• Radiological evaluation of pelvic ring reconstruction, joint integrity, and heterotopic ossification.

Main Results:

• 56% of patients were pain-free at follow-up; 44% reported some level of pain.
• No neurological deficits were observed; 25% experienced micturition or bowel dysfunction.
• Radiological reconstruction was achieved in 56%, but 31% had poor outcomes due to pain or urogenital issues.
• 13 pelvic lesions were initially missed on primary radiographs, including sacral fractures and triradiate cartilage injuries.

Conclusions:

• Complex pediatric pelvic trauma can result in significant long-term pain and functional deficits, despite good radiological reconstruction.
• Underdiagnosis of initial injuries, particularly subtle fractures, impacts long-term outcomes.
• Early and comprehensive radiological assessment is vital for optimal management and prognosis in pediatric pelvic trauma.