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Research

EPIDEMIOLOGY OF PAEDIATRIC PELVIC FRACTURES AND ASSOCIATED INJURIES IN THE WEST OF SCOTLAND

West of Scotland Orthopaedic Research Society (WOSORS)



Abstract

Pelvic fractures in children are uncommon. Despite their potentially serious nature, there is little information in the literature regarding their epidemiology.

We performed a retrospective review of case notes and radiographs, if available, of all patients admitted with bony pelvic injuries to our unit over a 28 year period (1980-2008). Sixty-four children with pelvic fractures were identified (median age 8 years, 75% male). 58% were pedestrians involved in road traffic accidents (RTA), 19% were caused by a fall from a height and 8% were crush injuries. There was seasonal variability, with a 50% increase in pelvic injuries in Autumn and 33% decrease in Winter - compared to Spring/Summer months (in contrast to the peak in overall fracture incidence in the Summer). Median length of stay was 8 days (range 1-180), 11% requiring direct admission to ITU and 5% to HDU. There is a high incidence of associated major injuries - for Stable fractures 52%, Partially stable fractures 60% and Unstable fractures 100%. Five required surgery to the bony pelvis, and 6 for-non pelvic orthopaedic injury. 3 required operative intervention from other specialities, 1 urological repair, 1 laparotomy and 1 lobectomy.

Pelvic fractures in children are potentially serious injuries with a high proportion of major associated injuries. Multiple injuries were sustained in 55% of pedestrian/RTA accidents, 100% of crush injuries and 58% of falls from a height. In this series, 52% of “Stable” pelvic injuries were associated with other major injuries. All paediatric pelvic injuries, even stable pubic rami fractures should be approached with caution, full ATLS assessment and close monitoring.