Open and contaminated pediatric pelvic ring injury case report: Fixation without metal

Dilworth, Brian; Riehl, John T.

doi:10.1016/j.ijscr.2017.05.029

Cited by 6 publications

(4 citation statements)

References 14 publications

(24 reference statements)

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“…The findings by Smith et al [ 14 ] suggested that in contrast to the previous belief that pelvic fractures in children would eventually remodel; pelvic asymmetry either persisted or increased with time. Currently, there is overall consensus in the literature that unstable pelvic fractures in children require operative intervention [ 1 – 3 , 5 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Open complete anterior dislocation of the sacro-iliac joint in a 4-year-old boy: a case report of a rare injury with 5-year follow-up

Elnahal¹,

Fahmy²,

Acharya³

2017

Strategies in Trauma and Limb Reconstruction

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Pelvic fractures are uncommon in children and account for between 0.3 and 7.5% of all pediatric injuries. Open pelvic fractures only account for up to 12.9% of all pediatric pelvic fractures. An unusual case of open complete anterior sacro-iliac joint dislocation in a 4-year-old boy is presented with a long-term follow-up. The multidisciplinary approach is reported with review of the current literature. A 4-year-old male presented to our institution in January 2012 after having been run over by a tractor. He presented with gross hemodynamical instability, MISS of 25, and an unstable lateral compression type III pelvic fracture with complete anterior dislocation of the left hemipelvis and a groin wound extending into the left thigh. The patient was managed in accordance with the ATLS and open fracture guidelines. Reduction in the dislocated SI joint was achieved via a posterior approach to the SI joint, followed by fixation with 2K wires in S1 and S2 sacral segments, with an anterior external fixator. Pelvic asymmetry post-reduction was 0.9 cm, compared to 16 cm post-injury, and asymmetry persisted till final follow-up at 5 years. At 5 years, patient regained full function, including recreational sport activities. Patients scored a 96/96 on the Majeed score (after excluding 4 points for sexual function). We believe that posterior reduction in an anteriorly dislocated SI joint in the pediatric population is a viable option. A coordinated, multidisciplinary approach and restoration of pelvic ring stability can lead to optimal outcome.

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Section: Discussionmentioning

confidence: 99%

Open complete anterior dislocation of the sacro-iliac joint in a 4-year-old boy: a case report of a rare injury with 5-year follow-up

Elnahal¹,

Fahmy²,

Acharya³

2017

Strategies in Trauma and Limb Reconstruction

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“…Fixation can then be deferred for several days to allow for surgery under more favourable conditions. Alternatively, osteosutures may have an advantage in open pelvic fractures as they can reduce the need for further dissection and the risk of infection as there is no metalware inserted 108 . New techniques include the use of an INFIX (Internal External Fixator) device for in children; this has been described for use in adults 109 .…”

Section: Investigations and Managementmentioning

confidence: 99%

“…Alternatively, osteosutures may have an advantage in open pelvic fractures as they can reduce the need for further dissection and the risk of infection as there is no metalware inserted. 108 New techniques include the use of an INFIX (Internal External Fixator) device for in children; this has been described for use in adults. 109 In an 8‐year‐old female with an MTZ IV injury, the INFIX was inserted without difficulty, held the reduction for 8 weeks before successfully removal and provided a less bulky and invasive alternative to external fixation.…”

Section: Investigations and Managementmentioning

confidence: 99%

Paediatric pelvic fractures – an updated literature review

Nguyen

Drynan

Holland

2022

ANZ Journal of Surgery

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Background: Pelvic fractures in children are indicative of significant trauma. Patients will often have associated injuriessome of which require urgent intervention to prevent death and disability. Paediatric and adult pelvises respond to traumatic forces differently and distinct approaches are required for each population. Historically, pelvic fractures have been treated conservatively, but this trend is changing with a better understanding of the pelvis' inability to remodel significant deformity, as well as new techniques for operative fixation. Methods: A comprehensive search of the literature was conducted for articles published between 2000 and 2020 on paediatric pelvic fractures using medical databases including PubMed, Embase and the Cochrane Library. Results: We included 143 studies in our literature review and summarized the incidence, pathophysiology, assessment, management and complications associated with paediatric pelvic fractures. Conclusions: The rarity of paediatric pelvic fractures corresponds with a paucity of randomized clinical trials covering this topic. Trends such as the screening pelvic x-ray are derived from adult populations but are now questioned in children. Other aspects of assessment and management of these children warrant such levels of scrutiny.

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“…For Children, however, the available literature on the treatment and short-term clinical outcomes of paediatric Open Pelvic fractures is scarce, and limited to a few case reports [ [9] , [10] , [11] ]. Moreover, there is a lack of data concerning long-term musculoskeletal function, growth deformities, and neurological and urogenital function following (non)operative treatment of Open Pelvic ring fractures in Children.…”

Section: Introductionmentioning

confidence: 99%

Long-term musculoskeletal function after Open PElvic ring fractures in Children (OPEC); a multicentre, retrospective case series with follow-up measurement

Mennen,

Van Lieshout,

Bisoen

et al. 2024

Trauma Case Reports

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Open and contaminated pediatric pelvic ring injury case report: Fixation without metal

Abstract: HighlightsOpen pelvic fractures can present unique and difficult clinical problems.The pelvic ring is a dynamic structure in normal physiologic conditions.Suture and anchor fixation can be used as definitive fixation of the pelvic ring.

Cited by 6 publications

References 14 publications

Open complete anterior dislocation of the sacro-iliac joint in a 4-year-old boy: a case report of a rare injury with 5-year follow-up

Open complete anterior dislocation of the sacro-iliac joint in a 4-year-old boy: a case report of a rare injury with 5-year follow-up

Paediatric pelvic fractures – an updated literature review

Long-term musculoskeletal function after Open PElvic ring fractures in Children (OPEC); a multicentre, retrospective case series with follow-up measurement

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