Long-term outcomes of conservatively treated paediatric pelvic fractures

Subaşı, Mehmet; Arslan, Hüseyin; Necmioğlu, Serdar; Önen, Abdurrahman; Özen, Şakir; Kaya, Mete

doi:10.1016/j.injury.2003.09.037

Cited by 26 publications

(23 citation statements)

References 15 publications

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“…Although severity of the injury (high ISS) had been associated to the complexity of the pelvic ring injury in previous studies [ 5 ], in our study mortality was not associated with the type of the pelvic injury. This has also been shown by Subasi et al [ 24 ]. Other authors though have associated increased mortality to the type [ 25 ] and complexity [ 4 ] of pelvic trauma.…”

Section: Discussionsupporting

confidence: 83%

Pelvic Fractures in Paediatric Polytrauma Patients: Classification, Concomitant Injuries and Early Mortality

Tosounidis¹,

Sheikh²,

Giannoudis³

2015

TOORTHJ

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Purpose of this Study : To review the characteristics, concomitant injuries and mortality in children with polytrauma and associated pelvic fractures treated in a Level-I Trauma Centre.Materials and Methods : Between December 2003 and November 2013, 49 children with an Injury Severity Score (ISS) of 16 or greater and a pelvic fracture met the inclusion criteria and were evaluated. The mortality, transfusion requirements and length of intensive care unit stay were correlated with the ISS, Abbreviated Injury Scale, concomitant limb and spine fractures, and type of pelvic ring injury (AO/OTA classification).Results : The mean ISS at presentation was 31.4 (range 16 to 57). 19 (38.7%) patients sustained a Type A, 27 (55.1%) a Type B and 3 (6.2%) a Type C injury. Head and face trauma was present in 33 (67.3%) cases. Blood transfusion during the resuscitation process was necessitated in six (12.2%) patients. Thirty-eight (77.5%) patients were managed non-operatively for their pelvic injuries. The mean duration of hospital stay was 23.9 days (range 1 to 146 days). In this cohort of polytrauma paediatric patients there were five (10.2%) mortalities (all suffered an associated head trauma ) within 30 days from the initial injury.Conclusion: Severe head injury and a high ISS are significantly associated with mortality in children with pelvic fractures. These patients have a high incidence of concomitant spine and chest injuries Hemorrhage due to pelvic injuries is rare. Severe head injuries predict a longer ICU stay in this population.

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Section: Discussionsupporting

confidence: 83%

Pelvic Fractures in Paediatric Polytrauma Patients: Classification, Concomitant Injuries and Early Mortality

Tosounidis¹,

Sheikh²,

Giannoudis³

2015

TOORTHJ

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“…The ultimate goal in managing a urethral injury is to avoid long-term sequelae and achieve adequate voiding function, continence and sexual potency. Of the complications that can ensue from PFUI, urethral stricture is the most commonly reported, with an incidence of 25% [21] . The treatment of post-traumatic urethral strictures in children presents a challenge to the urologist.…”

Section: Treatmentmentioning

confidence: 99%

Pelvic-fracture urethral injury in children

Hagedorn

Voelzke

2015

Arab Journal of Urology

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ObjectiveTo review paediatric posterior urethral injuries and the current potential management options; because urethral injury due to pelvic fracture in children is rare and has a low incidence, the management of this type of trauma and its complications remains controversial.MethodsWe reviewed previous reports identified by searching the PubMed Medline electronic database for clinically relevant articles published in the past 25 years. The search was limited to the keywords ‘pediatric’, ‘pelvic fracture’, ‘urethral injury’, ‘stricture’, ‘trauma’ and ‘reconstruction’.ResultsMost paediatric urethral injuries are a result of pelvic fractures after high-impact blunt trauma. After the diagnosis, immediate bladder drainage via a suprapubic cystotomy, or urethral realignment, are the initial management options, except for a possible immediate primary repair in girls. The common complications of pelvic fracture-associated urethral injury include urethral stricture formation, incontinence and erectile dysfunction. Excellent results can be achieved with delayed urethroplasty for pelvic fracture-associated urethral injuries.ConclusionTraumatic injury to the paediatric urethra is rare and calls for an immediate diagnosis and management. These devastating injuries have a high complication rate and therefore a close follow-up is warranted to assure adequate delayed repair by a reconstructive urologist.

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“…Mehmet reported that 68 % of pediatric pelvic-ring injuries is caused by auto-pedestrian accidents [5]. Pediatric pelvic fractures often result from high-energy trauma and have etiologies very different from those of adult pelvic fractures [6].…”

Section: Discussionmentioning

confidence: 99%