Pediatric pelvic fractures: Review of 52 patients

Fifty-two patients (ages 1 to 16 years) with pelvic fractures were hospitalized at an urban medical center during a 5-year period. All patients with acetabular fractures had adjacent hemipelvis fractures. None were seen to develop symptomatic acetabular dysplasia. Stable breaks in the ring (anterior ring fracture) were encountered most frequently. While many patients were discharged ambulating within a short time, over 50% had prolonged hospitalizations due to associated trauma. Only one child had serious urologic trauma, demonstrating that isolated anterior ring fractures in children are not as treacherous in terms of pelvic content injury as those one might encounter in adults. Unstable breaks (anterior and posterior ring fractures) pose acute and chronic management problems and associated injuries are often fatal. Life-threatening complications may overshadow proper fracture management. It is critical to maintain a symmetrical pelvis in order to prevent either cephalad translation or anterior-posterior hemipelvis rotation. A child with the latter problem is presented in detail.