- 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 polyfractures in children. Radiographic diagnosis and treatment.
Pelvic fractures and associated injuries in children.
Clinical Outcomes of Unstable Pelvic Fractures in Skeletally Immature Patients.
Pelvic Apophyseal Avulsion Fractures: A Retrospective Review of 228 Cases