Pelvic ring injuries in children. Part II: Treatment and results. A review of the literature.

Emergency treatment in the pediatric trauma patient with a pelvic fracture is orientated to the concepts established in adults (59). The main parameters in decision making are the hemodynamic situation and the grade of instability of the pelvis (36). It has to be considered that the child has a longer hemodynamic compensation before a severe shock state results in a potential near fatal situation. Hauschild et al. found that in children emergency measures were taken in 17.9% compared to a rate of 11.1% in adults patients (19). Due to the anatomical differences of the child’s pelvis and the higher risk of injury to the pelvic viscera, it has to be considered that the presence of pelvic and extremity fractures predicts concomitant abdominal and head injuries (5, 6, 50, 61) and therefore the overall risk of bleeding complications (5, 23, 30, 58, 61). Bleeding is commonly secondary to associated solid-organ injuries (6, 15, 23, 41, 43, 50, 58).