No abstract

We describe the case of an 8-year old female patient with an open pelvic fracture after being run over by a bus. Open pelvic injuries in pediatric patients are very rare and are associated with high mortality rates and long-term morbidity. In this case, a multidisciplinary surgical approach is described. The injuries include a complex pelvic ring fracture, which was treated with an internal external fixator, together with severe urogenital and soft-tissue injury. The internal external fixator, a surgical technique involving a temporary internal fixation device, is well described in adults, but has not been described in pediatric patients before. This case presentation shows the severity and complexity of the treatment of open pelvic fractures with severe associated injures. Albeit the treatment of her orthopaedic injuries has been successful so far, our patient unfortunately still suffers notable morbidity from her other injuries.

Aim: The study aims to determine the estimated radiation exposure of two different types of fixation (crossed vs lateral-entry K-wires) for displaced supracondylar fractures at a Major Trauma Centre in London. Methods: A retrospective review was performed between 2015 and 2019 in children (<16 years old) who underwent either Closed Reduction and Percutaneous Pinning (CRPP) or open reduction and K wire fixation for a displaced supracondylar fracture (Gartland II, III and IV) of the humerus. Results: The overall mean radiation dose and duration with crossed K-wire fixation was statistically lower when compared with two lateral K-wires. The mean radiation dose increased with increasing Gartland Grade - for Gartland Grades II, III and IV respectively. Conclusion: The current study showed statistically significant decreased radiation dose in crossed K-wire fixation method, compared to lateral-entry fixation. No difference was found regarding the cosmetic/functional outcome when Flynn’s criteria were applied.