Operative intervention of unstable paediatric pelvic fracture: radiological and functional assessment

Surgical management of paediatric pelvic fractures: a prospective case series and early experience from a level one Egyptian trauma centre

“…These inherent characteristics of the paediatric patients' pelvis encouraged more nonsurgical lines for PPF management, including bed rest, traction, pelvic slings, or hip spica casts [12,[25][26][27]. PPF treatment recommendations have changed during the last decade, with more surgeons suggesting surgical intervention [1,15,28], especially in unstable fracture patterns, to avoid late comorbidities associated with nonsurgical management options, including low back pain, LLD, early sacroiliac fusion, iliac wing, and hemipelvis undergrowth, which have been reported in up to 30% of the patients with PPF [13,26,27,29,30].…”

“…Signorino et al [ 35 ] and Zhu et al [ 11 ] used the more general WeeFIM instrument (formerly known as the Functional Independence Measure for Children), which assesses self-care, mobility, and cognition. In a recent study by Fahmy and Abdelmoneim, including 21 surgically treated patients with PPF, the authors evaluated the functional outcome through the functional independence measure questionnaire and the modified Merle d'Aubigne and Postel score in addition to reporting on LLD and gait pattern [ 15 ]. We found that the presence of associated injuries and increased length of hospital stay negatively affected the functional outcomes.…”

“…Galos and Doering reported that they routinely removed the external fixators by eight weeks and the ISSs by six months [ 14 ]; Oransky et al [ 30 ] also recommended removing all implants between three and four months post-operatively to avoid growth arrest. Fahmy and Abdelmoneim reported that they scheduled plate and screw removal in their patients during the latest follow-up visit; however, they did not report hardware removal data indications or obstacles encountered [ 15 ]. In contrast, Kruppa et al [ 7 ] selectively removed hardware as per patients’ request; they removed the hardware from only 3 of 16 patients (ISS, 3; symphyseal plate, 1) following fracture healing.…”

“…Although the principles of surgical management (resuscitation, provisional fixation, and definitive fixation) apply among various reports on PPF, no definite guidelines or consensus for surgical PPF management have been developed [ 14 ], which could be attributed to the rarity of these injuries and studies with small sample sizes [ 1 , 15 ]. Data related to PPF management are lacking in our areas (the Middle East and North Africa).…”

Admission maximum amplitude–reaction time ratio: Association between thromboelastography values predicts poor outcome in injured children

“…Functional independence measure is a standard data element in our state trauma registry that has been used in prior pediatric trauma studies to assess functional outcomes. [22][23][24] Different components of the functional independence measure score were included in the supplemental material (Supplemental Digital Content, Supplementary Data 1, http://links.lww.com/ TA/C782). Venous thromboembolism, which could include either deep vein thrombosis (DVT) or pulmonary embolism (PE), was recorded.…”