Pelvic fractures in children.

A retrospective study was performed on 141 patients with multiple injuries that included pelvis fractures. The mode of injury, type of fracture of the pelvis, associated injuries, morbidity and mortality, and outcome following healing of the fracture were studied. From this study a classification has been derived which appears to show a correlation among the type of pelvic fracture, the associated injuries, and the expected outcome from that fracture. Of the 141 patients, there were 11 deaths and 130 patients available for clinical review. The greatest morbidity, mortality, and complications from the fractures were in the type IV group, comprising patients with segmental instability of the pelvis. We suggest that computed tomographic scanning be used when segmental instability is suspected and when the posterior elements of the pelvis are difficult to examine by conventional radiographs. When there has been disruption of the acetabulum, then the treatment of choice is open reduction, stable fixation, and early motion. When there is segmental instability of the pelvis that cannot be controlled by conventional methods of pelvic slings or spica casts or when associated injuries preclude the use of these methods, then the treatment of choice should be external fixation.