Pelvic Fractures and Associated Injuries in Children

Abstract

The majority of pelvic fractures in children may be satisfactorily treated nonoperatively. Operative interventions were more frequently required for associated injuries. Long-term review is indicated because of delayed complications in children that are continuing to grow and develop.

Tratamento cirúrgico da fratura instável do anel pélvico em pacientes esqueleticamente imaturos

“…As fraturas do anel pélvico em pacientes esqueleticamente imaturos são relativamente raras, representam menos de 0,2% de todas as fraturas pediátricas e 1 a 5% das admissões em centros terciários de trauma infantil (1,2) . Geralmente causadas por trauma de alta energia é frequente a associação a outras lesões orgânicas (aparelho geniturinário, vísceras abdominais, sistema nervoso central, estruturas neurovasculares e musculoesqueléticas) (3) .…”

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

“…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%).…”

“…Thus, the presence of a pelvic fracture in a child is a marker of severe injury. Children with pelvic fractures may require blood transfusion; however, death by exsanguination or associated vascular injury is unlikely [17][18][19] as compared to adults because of more effective vasoconstrictive response with nonatherosclerotic blood vessels [20]. In children with unstable fracture patterns or uncontrolled hypotension with ongoing transfusion requirements, external fixation, angiography and selective embolization may be indicated.…”

“…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.…”

“…Pelvic fractures comprise of less than 0.2% of all paediatric fractures [14][15], but they constitute between 1% to 5% admissions to Level 1 paediatric trauma centres [16][17][18][19][20].…”