Analysis of the cause, classification, treatment, outcome and associated injuries of pediatric pelvic ring fractures

BACKGROUND: Although pediatric pelvis fractures are relatively uncommon, long-term consequences and associated life-treating injuries often have a substantial impact for the rest of a child's life. The prognosis of pediatric pelvic fractures is better than that of the adults because of their greater elasticity, healing capacity and re-modelling. Fractures through the physis may lead to growth disturbance and/or acetabular dysplasia. Non-union is rare and mal-union is usually well-tolerated. The purpose of this study was to evaluate the results of a single trauma center and review the literature approach to pediatric pelvic fractures. METHODS: Medical records were analyzed for diagnosis, the mechanism of injury, additional injuries, treatment methods, and complications. The types of fractures were classified according to Torode and Zieg classification. Patients were called back and seen at the clinic as a last follow up visit. RESULTS: Twenty eight skeletally immature patients, under the age of 12, were treated for pelvic fracture from 1997 to 2012. Mean age was 6.8 +/- 2.4 years. Three children with an unstable pelvic ring injury required pelvic external fixation. One patient died due to pelvic hemorrhage postoperatively. Mean follow up was 5.3 +/- 3.6 years. CONCLUSION: Pediatric pelvic fractures are rare but life-threating injuries. Overall good or excellent long-term results can be expected in most cases with appropriate timing and treatment.