Authors: Rosemary Nabaweesi Meghan A Arnold David C Chang Mark I Rossberg Susan Ziegfeld David E Sawaya Melinda A Bathurst Paul Colombani Fizan Abdullah
Publish Date: 2008/08/05
Volume: 24, Issue: 9, Pages: 1053-
Abstract
Pelvic fractures are uncommon in children but can occur as a result of highenergy impact injuries to the lower torso in association with blunt trauma Pelvic fractures can be associated with significant morbidity while the workup and treatment for these injuries is costly The aim was to identify risk factors that help determine which pediatric trauma patients are at highest risk of sustaining a pelvic fracture to aid in the development of criteria for the targeted use of pelvic radiographic imaging A retrospective analysis was conducted using the only pediatric trauma registry in the state of Maryland located at The Johns Hopkins Children’s Center All blunt trauma patients who were younger than 15 years of age from 1990 to 2005 were included in the analysis n = 13360 with a final diagnosis of pelvic fracture as the primary outcome of interest Comparisons were made using Pearson’s chisquare for categorical and the Mann–Whitney rank sum test for nonnormally distributed variables Pelvic fractures following blunt trauma in children are associated with age race place and mechanism of injury Compared to children 4 years and younger pelvic fractures were more likely to occur in children aged 5–9 years OR = 3 P = 0000 as well as 10–14 years OR = 5 P = 0000 Compared to blunt trauma injuries from falls children who were struck by vehicles or who were occupants in motor vehicle crashes MVC were six times P = 0000 and twice P = 002 as likely to sustain a pelvic fracture respectively Four factors were demonstrated by this study to be significantly associated with pediatric pelvic fractures being Caucasian age between 5 and 14 years being struck as a pedestrian or a motor vehicle crash occupant Identification of these factors may aid clinicians in selecting patients who are at highest risk for pelvic fracture and may benefit most from pelvic radiography
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