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Pediatric Pelvic Fractures

- Pediatric Acetabular Fractures

- Discussion:
    - characteristics of pediatric pelvic fracture:
          - in the report by Silber JS, et al, the authors identified 166 consecutive pelvic fractures;
                - physes were scored as open, narrowed, or closed;
                - risser sign, fracture pattern, survival after injury, and need for open reduction and internal fixation were recorded;
                - 97 patients (mean age 5.7 years) had an open triradiate or an "immature pelvis."
                - 32 patients (mean age 14 years) had a closed triradiate cartilage or a "mature pelvis."
                - immature group had a higher propensity for isolated pubic rami and iliac wing fractures.
                        - management of fractures to the immature pelvis should focus on associated injuries.
                - mature group had a higher predilection for acetabular fractures and pubic or sacroiliac diastasis.
                        - all patients requiring open reduction and internal fixation had a mature pelvis.
                        - once the triradiate cartilage has closed, adult pelvic fracture classifications and management principles should be used;
                - ref: Changing patterns of pediatric pelvic fractures with skeletal maturation: implications for classification and management.

- Treatment:
    - in the report by Blasier RD, et al (2000)
           - the authors retrospectively reviewed the medical records and radiographs of 189 patients with pelvic ring disruptions who were
                       evaluated at a tertiary care children's hospital during a 10-year period.
           - of the 189 patients, 57 were identified with unstable pelvic fractures.
           - 43 of these patients were available to complete a subjective evaluation of their treatment at midterm followup.
           - 13 patients were treated operatively and 30 were treated nonoperatively.
           - there was no significant difference in subjective scoring between the two groups for pain at rest, pain with activity, limp, leg length
                       discrepancy, and overall satisfaction with treatment.
           - there were 92% good or excellent results in the patients who were treated operatively and 80% good or excellent results in the patients
                       who were treated nonoperatively. 
           - Disruption of the pelvic ring in pediatric patients.

Pediatric pelvic ring injuries: How benign are they?

Pediatric pelvic ring fractures

Selective management of pediatric pelvic fractures: a conservative approach.

Pelvic fractures in children--review of 120 patients with a new look at general management.

Pelvic disruptions in children.

Death from pelvic fracture: children are different

Pelvic fractures in children.

Pelvic polyfractures in children. Radiographic diagnosis and treatment.

Pelvic fractures and associated injuries in children.

Unstable paediatric pelvic injuries the patho-anatomical patterns of pelvic ring failure and the role of avulsion of the iliac apophysis

Clinical Outcomes of Unstable Pelvic Fractures in Skeletally Immature Patients.

Pelvic Apophyseal Avulsion Fractures: A Retrospective Review of 228 Cases

The Role of Clinically Significant Venous Thromboembolism and Thromboprophylaxis in Pediatric Patients With Pelvic or Femoral Fractures