Pediatric pelvic fractures and differences compared with the adult population

Autores de IIS La Fe

• Carolina De La Calva Ceinós

  Autor

• Nadia Jover Jorge

  Autor

• Jaime Alonso Perez-Barquero

  Autor

• Marta Salom Taverner

  Autor

Grupos

• Cirugía Ortopédica y Traumatología

Abstract

Introduction Although pelvic fractures in children are rare, because of anatomical differences between an adult's skeleton and a child's skeleton, these lesions in the pediatric population have specific characteristics that need to be borne in mind when dealing with them. Materials and Methods A retrospective chart review was performed on the pelvic fractures in skeletally immature patients treated in our hospital in the last 20 years. Results Eighty-one pelvic fractures in children were treated between 1993 and 2013. The mean age was 9.98 years, with 61.7%(50/81) boys and 38.2% (31/81) girls. A traffic accident was the main injury mechanism (74%, 60/81), and height fall was in second place (16%, 13/81). Following Tile pelvic fracture classification, type A2 was the most frequent (58.04%, 47/81); and following Torode and Zieg classification, type IIIA (45.68%, 37/81). Associated injuries were present in 77.8% (63/81) of the patients; fractures of other bones and head trauma were the most frequent. An acetabular fracture was present in 13.5% (11/81) of the patients. Nonsurgical treatment was chosen for all the pelvic fractures except in 4 patients, which required surgical management for their pelvic injuries. Blood transfusion was required in 32% (26/81) of the patients, and arterial embolization was not needed in any case. Furthermore, 11.1% (9/81) required a stay in the pediatric care unit, and the death rate was 8.64% (7/81). The mean length of hospital stay was 12.4 days. Conclusions Because of the specific characteristics of pelvic fractures in children, fracture patterns are less severe than those of adults, but the injury mechanisms are high-energy traumas. The rate of associated injuries is very high, and a multidisciplinary management in pediatric trauma centers is needed to treat these patients. © Wolters Kluwer Health, Inc. All rights reserved.

Keywords

• Adolescent; Adult; Blood Transfusion; Child; Child, Preschool; Female; Fractures, Bone; Humans; Infant; Length of Stay; Male; Multiple Trauma; Pelvic Bones; Retrospective Studies; acetabulum fracture; adolescent; adult; arterial embolization; Article; blood transfusion; child; childhood injury; classification; controlled study; emergency ward; female; head injury; hospital admission; human; ICD-9; infant; major clinical study; male; medical record review; pedestrian; pediatric intensive care unit; pelvis fracture; retrospective study; torode and zieg classification; traffic accident; classification; comparative study; fracture; injury; length of stay; multiple trauma; pelvic girdle; preschool child