Abstract
BackgroundPediatric 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.MethodsThis 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.ResultsDuring 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%.ConclusionPPF 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.
Highlights
Pediatric pelvic fractures (PPF) are uncommon with the reported incidence ranges between 0.3 and 4.0% among children required hospitalization after blunt trauma [1, 2]
PPF are uncommon and mainly caused by high-impact trauma associated with multisystem injuries
This is a retrospective review of prospectively collected data obtained from trauma registry database at Hamad General Hospital (HGH) which has a designated as the only level 1 trauma center in the country
Summary
Pediatric pelvic fractures (PPF) are uncommon with the reported incidence ranges between 0.3 and 4.0% among children required hospitalization after blunt trauma [1, 2]. This frequency of pelvic fractures is relatively lower in pediatrics as compared to adults which could be attributed to the existence of anatomical differences between the two populations [3]. 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]. 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
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