Analysis of the Cause, Classification, and Associated Injuries of 166 Consecutive Pediatric Pelvic Fractures

Malgaigne Pelvic Fractures in Children- an unusual unstable fracture pattern of pelvic fractures

“…The incidence is comparable to the adults with regard to abdominal injury in association with pelvic fractures [18]. It is very important to recognize them early as abdominal injury ranks second to the head injury as a cause of death in children with pelvic fractures [22]. CT scan, ultrasound and diagnostic peritoneal lavage help in diagnosing these injuries.…”

“…In addition, sacroiliac joint and symphysis pubis have greater elasticity, thereby requiring higher energy to cause it to fracture than in adult pelvis [22]. Thus, the presence of a pelvic fracture in a child is a marker of severe injury.…”

“…The two largest single centre retrospective studies of paediatric pelvic fractures by Silber, et al [22] and Tarman, et al [30] reported 1% incidence of lower urinary tract injury in association with pelvic fracture. Although controversial, most authors agree that microhematuria can be followed expectantly, whereas patients with gross hematuria should undergo imaging with abdominopelvic computed tomography (CT), retrograde urography, and cystography [29].…”

“…In a published clinical series involving 585 patients with pelvic fractures, 87% were reported as having at least one, and often several, associated injuries [17][18][21][22][23]. Grisoni,et al [19] reported in their series, 58% with involvement of one or more other body areas, including nonpelvic fractures (49%), neurological injury (26%), significant haemorrhage requiring transfusion (21%), abdominal injury (14%), thoracic injury (7%), and genitourinary injury (4%).…”

“…Fractures of other bones occur to the tune of 40%-50% cases [17,19,[21][22][23]26] and femur as the most frequent fractures [25]. neurological examination of the extremities assisted by myelography with computed axial tomography or magnetic resonance imaging (MRI) is useful for establishing the diagnosis of lumbosacral plexus or root avulsion injury.…”