Unstable pelvic ring fracture in an immature skeleton: case report

Authors

  • Rodrigo Huertas Tafur Instituto de Ortopedia Infantil Roosevelt. Bogotá, Colombia
  • Gilberto Herrera Ortiz Instituto de Ortopedia Infantil Roosevelt. Bogotá, Colombia
  • Jenny Holguín Pontificia Universidad Javeriana. Bogotá, Colombia
  • Bárbara Gómez Eslava Pontificia Universidad Javeriana. Bogotá, Colombia
  • Ricardo Méndez Instituto de Ortopedia Infantil Roosevelt. Bogotá, Colombia

DOI:

https://doi.org/10.1016/j.rccot.2016.10.007

Keywords:

tnstable pelvic ring fracture, pediatric trauma, fracture fixation, multiple trauma

Abstract

The unstable pelvic ring fracture is a rare traumatic pathology in pediatric population. The literature describes an incidence between 0.5 and 2.4% in referral centers for trauma, including stable and acetabular fractures. It requires quick action on admission at the hospital, initially stabilizing the patient, and subsequently obtaining sufficient evidence for complete diagnostic evaluation of pelvic trauma in order to define classification and treatment. We describe herein a case of a patient with multiple injuries, aged 29 months, victim of a traffic accident as a pedestrian, and the surgical treatment performed on the patient.
Evidence level: IV.

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Author Biographies

Rodrigo Huertas Tafur, Instituto de Ortopedia Infantil Roosevelt. Bogotá, Colombia

Ortopedista Infantil, Instituto de Ortopedia Infantil Roosevelt, Bogotá, Colombia.

Gilberto Herrera Ortiz, Instituto de Ortopedia Infantil Roosevelt. Bogotá, Colombia

Ortopedista Infantil, Instituto de Ortopedia Infantil Roosevelt, Bogotá, Colombia.

Jenny Holguín, Pontificia Universidad Javeriana. Bogotá, Colombia

Miembro de la junta de gobierno de Ortopedia y Traumatología, Pontificia Universidad Javeriana, Bogotá, Colombia.

Bárbara Gómez Eslava, Pontificia Universidad Javeriana. Bogotá, Colombia

Residente de Ortopedia y Traumatología, Pontificia Universidad Javeriana, Bogotá, Colombia.

Ricardo Méndez, Instituto de Ortopedia Infantil Roosevelt. Bogotá, Colombia

Médico Epidemiólogo, Instituto de Ortopedia Infantil Roosevelt, Bogotá, Colombia.

References

Holden CP, Holman J, Herman MJ. Pediatric pelvic fractures. J Am Acad Orthop Surg. 2007;15:172-7. https://doi.org/10.5435/00124635-200703000-00007

Pandya NK, Upasani VV, Kulkarni VA. The pediatric polytrauma patient: Current concepts. J Am Acad Orthop Surg. Am Acad Ortho Surgeons. 2013;21:170-9. https://doi.org/10.5435/00124635-201303020-00006

Gänsslen A, Heidari N, Weinberg AM. Fractures of the pelvis in children: a review of the literature. Eur J Orthop Surg Traumatol. 2013;23:847-61. https://doi.org/10.1007/s00590-012-1102-0

Karunakar MA, Goulet JA, Mueller KL, Bedi A, Le TT. Operative treatment of unstable pediatric pelvis and acetabular fractures. J Pediatr Orthop. 2005;25:34-8. https://doi.org/10.1097/00004694-200501000-00009

Tuovinen H, Söderlund T, Lindahl J, Laine T, Åström P, Handolin L. Severe pelvic fracture-related bleeding in pediatric patients: does it occur. Eur J Trauma Emerg Surg. 2012;38:163-9. https://doi.org/10.1007/s00068-011-0140-3

Lane-O'Kelly A, Fogarty E, Dowling F. The pelvic fracture in childhood: a report supporting nonoperative management. Injury. 1995;26:327-9. https://doi.org/10.1016/0020-1383(95)00028-8

Signorino PR, Densmore J, Werner M, Winthrop A, Stylianos S, Guice KS, et al. Pediatric pelvic injury: functional outcome at 6-month follow-up. J Pediatr Surg. 2005;40:107-13. https://doi.org/10.1016/j.jpedsurg.2004.09.018

Guillamondegui OD, Mahboubi S, Stafford PW, Nance ML. The utility of the pelvic radiograph in the assessment of pediatric pelvic fractures. J Trauma Acute Care Surg. 2003;55: 236-40. https://doi.org/10.1097/01.TA.0000079250.80811.D1

Nieto-Lucio L, Camacho-González S, Reinoso-Pérez JR. Tratamiento de las fracturas de pelvis inestable tipo IV de la clasificación de Torode y Zieg en niños. Acta Ortopédica Mex. 2010;24:338-44.

Schwarz N, Posch E, Mayr J, Fischmeister FM, Schwarz AF, Öhner T. Long-term results of unstable pelvic ring fractures in children. Injury. 1998;29:431-3. https://doi.org/10.1016/S0020-1383(98)00074-6

Cothren CC, Moore EE, Smith WR, Morgan SJ. Preperitoneal pelvic packing in the child with an unstable pelvis: a novel approach. J Pediatr Surg. 2006;41:e17-9. https://doi.org/10.1016/j.jpedsurg.2006.01.014

Holt GE, Mencio GA. Pelvic C-clamp in a pediatric patient. J Orthop Trauma. 2003;17:525-7. https://doi.org/10.1097/00005131-200308000-00009

Baskin KM, Cahill AM, Kaye RD, Born CT, Grudziak JS, Towbin RB. Closed reduction with CT-guided screw fixation for unstable sacroiliac joint fracture-dislocation. Pediatr Radiol. 2004;34:963-9. https://doi.org/10.1007/s00247-004-1291-8

Starr AJ, Ortega G, Reinert CM. Management of an unstable pelvic ring disruption in a 20-month-old patient. J Orthop Trauma. 2009;23:159-62. https://doi.org/10.1097/BOT.0b013e31819866b5

Smith W, Shurnas P, Morgan S, Agudelo J, Luszko G, Knox EC, et al. Clinical outcomes of unstable pelvic fractures in skeletally immature patients. J Bone Joint Surg. 2005;87: 2423-31. https://doi.org/10.2106/00004623-200511000-00008

Upperman JS, Gardner M, Gaines B, Schall L, Ford HR. Early functional outcome in children with pelvic fractures. J Pediatr Surg. 2000;35:1002-5. https://doi.org/10.1053/jpsu.2000.6953

Published

2016-11-02

How to Cite

1.
Huertas Tafur R, Herrera Ortiz G, Holguín J, Gómez Eslava B, Méndez R. Unstable pelvic ring fracture in an immature skeleton: case report. Rev. Colomb. Ortop. Traumatol. [Internet]. 2016 Nov. 2 [cited 2025 May 10];30(3):117-21. Available from: https://revistasccotorg.biteca.online/index.php/rccot/article/view/394

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Section

Case report