Management of an Unstable Pelvic Ring Disruption in a 20-Month-Old Patient

Abstract

A 20-month-old patient with a markedly displaced pelvic ring disruption was successfully managed with fluid resuscitation, immobilization using bolsters, and percutaneous screw fixation of the posterior ring coupled with hip spica casting.

Fracture-dislocation of the sacroiliac joint with severely unstable fractures of the pelvis and femur in a 16-month-old patient: a case report

“…With regard to grossly unstable SI joints, we felt that the risks of conservative management outweighed the risks of surgery in this patient [2], and open reduction is often warranted in skeletally immature patients. Hoffmann et al [17] described a unilateral SI hinge fixation in association with an anterior osteosynthesis to treat SI joint dislocation, achieving good clinical results.…”

“…There are few literature reports of unstable pelvic fracture in infants \2 years old; however, Starr et al [2] reported on a 20-month-old patient. In this study, we present a rare case of sacroiliac (SI) joint dislocation associated with acetabulum, femur, and pubic rami fractures in a 16-month-old patient, making reduction and fixation more difficult than in a case of simple anterior dislocation of the SI joint.…”

Pediatric-Specific Lesions in Unstable Pelvic Ring Fractures of Skeletally Immature Children: Impact on Diagnosis and Management Decisions

“…Pediatric pelvic fracture studies reported their safe use as early as 20 months of age, with no reported cases of neurologic compromise. 6,38,39 In a study of pelvic CT scans of children aged between 2 and 16 years by Burn et al 40 , safe pathways larger than 7 mm were available for ISS placement in 99% of S1 levels and for TSTI screws in 89% of S2 levels.…”