Pelvic fractures in children and adolescents in polytrauma and high-energy injuries.

BACKGROUND This paper is a retrospective analysis of the treatment of pelvic fractures in children and adolescents who sustained polytrauma and high-energy injuries. Incidence varies from 0.2% to 7.5% of all pediatric injuries. Most often, these are isolated stable fractures that do not require hospitalization. However, a group of unstable fractures requiring surgical intervention remains. MATERIAL AND METHODS 37 patients aged 5 to 17 years (mean: 13.6), were hospitalized between 2002 and 2010. This group comprised 21 boys and 16 girls who were followed up for 1 to 8 years (mean: 3.2). In this cohort, only cases of pelvic fractures that required hospitalization for other reasons were taken into account. The causes of injuries were car accidents, falls from bicycles and sports injuries. The Torode and Zieg classification was used for assessment, including surgical guidance by Mears/Gordon. RESULTS There were 11 cases of type I, 7 cases of type II and III and 9 cases of type IV fractures. Moreover, 3 cases of S-H II acetabular fractures were identified. The surgical treatment made use of external pelvic fixators, combined internal coaptation with cannulated screws or K-wires, and LCP plates or combined techniques. CONCLUSIONS 1. Torode and Zieg type I to III pelvic fractures in children do not usually require surgical treatment. 2. To rode and Zieg type IV unstable fractures require operative treatment in order to avoid complications and aid faster recovery.