Literature DB >> 25528624

Surgical treatment for unstable pelvic fractures in skeletally immature patients.

Joao Antonio Matheus Guimarães1, Pedro Henrique B Mendes2, Frederico C M Vallim2, Leonardo R Rocha2, Tito H N Rocha2, Isabel Cristina C do Val3, Maria Eugenia L Duarte2.   

Abstract

OBJECTIVE: To present the results and conclusions of our study on surgical treatment for unstable pelvic fractures in children subjected to surgical reduction and stabilisation.
METHODS: We analysed the cases of fourteen skeletally immature patients with unstable pelvic fractures who underwent surgery for this condition between March 2004 and January 2011. The surgical technique used was based on the principle of surgical reduction and stabilisation of anterior and posterior lesions of the pelvic ring. This was a retrospective study, based on clinical assessment and X-ray analyses.
RESULTS: The mean age of patients at the time of the condition was 9.4 years (range 2-13 years). Eight patients were female and six were male. The cause of the trauma was being hit by a car in ten cases, falls in three cases and an accident involving a motorcycle in one case. Five patients presented with other associated injuries, including fracture of the clavicle, femur shaft, proximal humerus, tibial shaft or olecranon, and bladder damage. All the patients assessed showed excellent clinical progress. Pelvic asymmetry prior to surgery varied from 1.1 to 2.9 cm (mean 1.5 cm) and dropped to a range of 0.2 to 0.9 cm (mean 0.4 cm) after reduction. In none of the cases was there a change between the pelvic asymmetry measured immediately after surgery and at the end of the follow-up period.
CONCLUSION: Pelvic fracture in skeletally immature patients is rare and surgery is not normally indicated. Various authors have questioned this conservative type of treatment due to complications encountered. Bone remodelling does not seem to be sufficient to ensure an improvement in pelvic asymmetry, which justifies opting for surgery to reduce and correct deformities in the pelvic ring.
Copyright © 2014 Elsevier Ltd. All rights reserved.

Entities:  

Keywords:  Children; Pelvic asymmetry; Pelvic ring; Reduction; Skeletally immature patients; Stabilisation; Unstable pelvic fracture

Mesh:

Year:  2014        PMID: 25528624     DOI: 10.1016/S0020-1383(14)70020-8

Source DB:  PubMed          Journal:  Injury        ISSN: 0020-1383            Impact factor:   2.586


  5 in total

Review 1.  Pelvic ring injuries: Surgical management and long-term outcomes.

Authors:  Mohamad J Halawi
Journal:  J Clin Orthop Trauma       Date:  2015-09-02

2.  Paediatric pelvic injuries: a retrospective epidemiological study from four level 1 trauma centers.

Authors:  Martin Salášek; Petr Havránek; Vojtěch Havlas; Tomáš Pavelka; Tomáš Pešl; Andrej Stančák; Jan Hendrych; Valér Džupa
Journal:  Int Orthop       Date:  2021-07-04       Impact factor: 3.075

3.  The application of lateral-rectus approach on toddlers' unstable pelvic fractures.

Authors:  Yuancheng Liu; Xiaorui Zhan; Fuming Huang; Xiangyuan Wen; Yuhui Chen; Cheng Yang; Shicai Fan
Journal:  BMC Musculoskelet Disord       Date:  2020-03-04       Impact factor: 2.362

4.  Surgical management of paediatric pelvic fractures: a prospective case series and early experience from a level one Egyptian trauma centre.

Authors:  Mohamed Arafa; Ahmed A Khalifa; Ali Fergany; Mostafa A Abdelhafez; Aly Mohamedean; Faisal Fahmy Adam; Osama Farouk
Journal:  Int Orthop       Date:  2022-07-23       Impact factor: 3.479

5.  Outcomes following pelvic ring fractures in the paediatric population: A systematic review.

Authors:  Sarup S Sridharan; Daniel You; Brett Ponich; David Parsons; Prism Schneider
Journal:  J Clin Orthop Trauma       Date:  2020-10-15
  5 in total

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