Pelvic Injury in Childhood: What Is Its Current Importance?

Guerra, María Roxana Viamont; Braga, Susana Reis; Akkari, Miguel; Santili, Cláudio

doi:10.1590/1413-785220162403157540

Cited by 6 publications

(8 citation statements)

References 17 publications

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“…However, it did not consider the bony pelvis’ changing maturity throughout the children’s age range. In our cohort, Torode type III was the most common pelvic ring injury (68.3%) which is similar to what has been reported previously [ 6 , 8 , 18 ]. On the other hand, Niedzielki et al [ 21 ] reported that the frequent type of fracture among children is avulsion fractures secondary to sports injuries.…”

Section: Discussionsupporting

confidence: 91%

“…High-energy blunt trauma is the leading mechanism of pediatric pelvic fractures primarily due to motor vehicle accidents and fall from height [2][3][4]. Pelvic fracture in pediatric population is a marker of the injury severity which showed association with injuries to the head and intra-abdominal region and greater risk of hemorrhage [2,8,9]. Hemorrhage as reported in adult pelvic fractures that leads to hemodynamic instability is rarely observed in pediatric pelvic fracture [2,10].…”

Section: Introductionmentioning

confidence: 99%

“…Usually solid organ injuries resulted from high-energy trauma are mostly the primary source of bleeding in children [ 1 , 2 , 11 ]. The adults have higher rate of mortality secondary to the pelvic fracture than the pediatric patients, in which death occurs primarily due to injuries to other body regions particularly the head [ 1 , 8 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics, injury pattern and management of pediatric pelvic fracture: An observational retrospective study from a level I trauma center

Alhammoud

Moghamis

Abdelrahman

et al. 2021

BMC Musculoskelet Disord

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Background Pediatric pelvic fractures (PPF) are uncommon among children requiring hospitalization after blunt trauma. The present study explored our experience for the prevalence, patients demographics, clinical characteristics, injury pattern and management of pediatric pelvic fractures in a level I trauma center. Methods This is a retrospective review of prospectively collected data obtained from trauma registry database for all pediatrics trauma patients of age ≤18 years. Data were analyzed according to different aspects relevant to the clinical applications such as Torode classification for pelvic ring fracture (Type I–IV), open versus closed triradiate cartilage, and surgical versus non-surgical management. Results During the study period (3 and half years), a total of 119 PPF cases were admitted at the trauma center (11% of total pediatric admissions); the majority had pelvic ring fractures (91.6%) and 8.4% had an acetabular fracture. The mean age of patients was 11.5 ± 5.7, and the majority were males (78.2%). One hundred and four fractures were classified as type I (5.8%), type II (13.5%), type III (68.3%) and type IV (12.5%). Patients in the surgical group were more likely to have higher pelvis AIS (p = 0.001), type IV fractures, acetabular fractures and closed triradiate cartilage as compared to the conservative group. Type III fractures and open triradiate cartilage were significantly higher in the conservative group (p < 0.05). Patients with closed triradiate cartilage frequently sustained spine, head injuries, acetabular fracture and had higher mean ISS and pelvis AIS (p < 0.01) than the open group. However, the rate of in-hospital complications and mortality were comparable among different groups. The overall mortality rate was 2.5%. Conclusion PPF are uncommon and mainly caused by high-impact trauma associated with multisystem injuries. The majority of PPF are stable, despite the underlying high-energy mechanism. Management of PPF depends on the severity of fracture as patients with higher grade fractures require surgical intervention. Furthermore, larger prospective study is needed to understand the age-related pattern and management of PPF.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics, injury pattern and management of pediatric pelvic fracture: An observational retrospective study from a level I trauma center

Alhammoud

Moghamis

Abdelrahman

et al. 2021

BMC Musculoskelet Disord

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“…129 Extra-pelvic injuries While rare, the urogenital system can be injured anywhere from the kidneys to the urethral opening following blunt abdominal trauma. 133,134 Surgeons should be mindful of patients with MTZ III and above pelvic fractures who also present with haematuria, dysuria, urinary retention or incontinence. 134,135 Organs such as the kidney are relatively larger in the child, and the perirenal fat is not as well developed to cushion against injury.…”

Section: Pelvic and Functional Complicationsmentioning

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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“…그렇기 때문에 세심한 이학적 검사와 관찰, 그리고 방 사선 검사가 필요하다. 특히나 CT를 이용한 골절의 검사는 동반 된 골반과 복부 장기의 손상을 검사할 수 있을 뿐만 아니라 3차원적 영상으로 골절을 보다 쉽게 이해하게 도와준다 5,6).…”

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Conservative Treatment of Physeal Bar after Triradiate Cartilage Injury

Han

2018

J Korean Orthop Assoc

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We report a patient who experienced no function problems during the 5-year follow-up after a conservative treatment for minimally displaced acetabular fracture that developed as a result of the formation of physeal bar. According to the computed tomography, triradiate cartilage was fractured and minimally displaced, which was identified as a Salter Harris type II physeal injury. A fracture of the anterior wall of the acetabulum was also observed. It was judged as a stable fracture, and conservative treatment was performed. On the followup x-ray, the physeal bar was formed in the damaged triradiate cartilage. At 5-year follow-up, physeal injury of the triradiate cartilage has influenced the acetabular growth, resulting in acetabular dysplasia, pelvic asymmetry, hypoplasia of pubis, and widening of the tear drop. However, anteversion and inclination of the injured acetabulum were similar with those of the contralateral side. Our patient also did not complain of any hip discomfort.

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Pelvic Injury in Childhood: What Is Its Current Importance?

Cited by 6 publications

References 17 publications

Clinical characteristics, injury pattern and management of pediatric pelvic fracture: An observational retrospective study from a level I trauma center

Clinical characteristics, injury pattern and management of pediatric pelvic fracture: An observational retrospective study from a level I trauma center

Paediatric pelvic fractures – an updated literature review

Conservative Treatment of Physeal Bar after Triradiate Cartilage Injury

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