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Paediatric pelvic fractures: how do they differ from adults?

BACKGROUND: The aim of this article was to review the incidence, presentation, treatment and complications of paediatric pelvic fractures of children who were admitted to our level 1 trauma centre and to compare them with our data from adult pelvic fracture patients. METHODS: We conducted a retrospe...

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Autores principales: Hermans, E., Cornelisse, S. T., Biert, J., Tan, E. C. T. H., Edwards, M. J. R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Editorial Society of Bone and Joint Surgery 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5382336/
https://www.ncbi.nlm.nih.gov/pubmed/28439309
http://dx.doi.org/10.1302/1863-2548-11-160138
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author Hermans, E.
Cornelisse, S. T.
Biert, J.
Tan, E. C. T. H.
Edwards, M. J. R.
author_facet Hermans, E.
Cornelisse, S. T.
Biert, J.
Tan, E. C. T. H.
Edwards, M. J. R.
author_sort Hermans, E.
collection PubMed
description BACKGROUND: The aim of this article was to review the incidence, presentation, treatment and complications of paediatric pelvic fractures of children who were admitted to our level 1 trauma centre and to compare them with our data from adult pelvic fracture patients. METHODS: We conducted a retrospective chart review of all children with pelvic fractures who were managed at our institution between January 1993 and December 2013 and compared the data with our database on pelvic fractures in adults during the period 2007 to 2012. RESULTS: We identified 51 children and 268 adults with pelvic fractures. The median age of the paediatric patients was 11 years. Children were significantly more involved in traffic accidents than adults (p < 0.001). Adults had a significantly higher Injury Severity Score (ISS) (31 vs 24.5; p < 0.03) and were significantly more often haemodynamically unstable (p < 0.01). Adults had a type C fracture more often, while children had a type B fracture (p < 0.001). Associated injuries were seen in both groups; however, thoracic injuries were significantly higher in adults (p < 0.01) and injuries to the extremities were higher in children (p < 0.01). Adults were significantly more often treated with open reduction and internal fixation (p < 0.001). Mortality in both groups, however, did not differ (6% vs 8%). CONCLUSION: Paediatric pelvic fractures are rare. They differ from adult pelvic fractures in presentation, associated injuries and management. Mortality, however, is substantial and does not differ from the adult population. Mortality is often due to concomitant injuries and not to exsanguination from the pelvic fracture.
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spelling pubmed-53823362017-04-24 Paediatric pelvic fractures: how do they differ from adults? Hermans, E. Cornelisse, S. T. Biert, J. Tan, E. C. T. H. Edwards, M. J. R. J Child Orthop Original Clinical Article BACKGROUND: The aim of this article was to review the incidence, presentation, treatment and complications of paediatric pelvic fractures of children who were admitted to our level 1 trauma centre and to compare them with our data from adult pelvic fracture patients. METHODS: We conducted a retrospective chart review of all children with pelvic fractures who were managed at our institution between January 1993 and December 2013 and compared the data with our database on pelvic fractures in adults during the period 2007 to 2012. RESULTS: We identified 51 children and 268 adults with pelvic fractures. The median age of the paediatric patients was 11 years. Children were significantly more involved in traffic accidents than adults (p < 0.001). Adults had a significantly higher Injury Severity Score (ISS) (31 vs 24.5; p < 0.03) and were significantly more often haemodynamically unstable (p < 0.01). Adults had a type C fracture more often, while children had a type B fracture (p < 0.001). Associated injuries were seen in both groups; however, thoracic injuries were significantly higher in adults (p < 0.01) and injuries to the extremities were higher in children (p < 0.01). Adults were significantly more often treated with open reduction and internal fixation (p < 0.001). Mortality in both groups, however, did not differ (6% vs 8%). CONCLUSION: Paediatric pelvic fractures are rare. They differ from adult pelvic fractures in presentation, associated injuries and management. Mortality, however, is substantial and does not differ from the adult population. Mortality is often due to concomitant injuries and not to exsanguination from the pelvic fracture. The British Editorial Society of Bone and Joint Surgery 2017 /pmc/articles/PMC5382336/ /pubmed/28439309 http://dx.doi.org/10.1302/1863-2548-11-160138 Text en Copyright © 2017, The British Editorial Society of Bone and Joint Surgery: All rights reserved http://creativecommons.org/licenses/by-nc/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.
spellingShingle Original Clinical Article
Hermans, E.
Cornelisse, S. T.
Biert, J.
Tan, E. C. T. H.
Edwards, M. J. R.
Paediatric pelvic fractures: how do they differ from adults?
title Paediatric pelvic fractures: how do they differ from adults?
title_full Paediatric pelvic fractures: how do they differ from adults?
title_fullStr Paediatric pelvic fractures: how do they differ from adults?
title_full_unstemmed Paediatric pelvic fractures: how do they differ from adults?
title_short Paediatric pelvic fractures: how do they differ from adults?
title_sort paediatric pelvic fractures: how do they differ from adults?
topic Original Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5382336/
https://www.ncbi.nlm.nih.gov/pubmed/28439309
http://dx.doi.org/10.1302/1863-2548-11-160138
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