Authors: H Tuovinen T Söderlund J Lindahl T Laine P Åström L Handolin
Publish Date: 2011/08/09
Volume: 38, Issue: 2, Pages: 163-169
Abstract
Pediatric pelvic fractures are rare and less likely to cause hemodynamic instability than similar injuries in adult patients The associated injuries are common and they have a major impact on mortality The aim of the present study was to evaluate the risk of lifethreatening hemorrhage associated with unstable pelvic fractures in childrenWe identified retrospectively all pediatric pelvic fractures ring and acetabulum treated at Helsinki University Central Hospital during a 10year period 1998–2007 Stable Atype fractures fractures not involving the pelvic ring were excluded All available pre and inhospital medical records were reviewed The collected data consisted of patient characteristics mechanisms of injury vital signs laboratory tests care given other injuries diagnosed and the 30day survival rateThere were 71 40 males pediatric patients median age 14 range 1–16 years with unstable pelvic fractures 66 pelvic ring and 5 acetabulum fractures The most common mechanism of injury was traffic accident 69 Four patients had lifethreatening bleeding All had fracture of a mature pelvic ring but the source of massive bleeding was pelvic ring fracture in only two patients 28 of all patients No acetabulum fracturerelated major pelvic bleeding was observed One patient age 16 years required emergency surgery and angioembolization for pelvic bleeding No lifethreatening pelvic bleeding was seen among patients with immature bony pelvis Pelvic ring fractures were surgically treated in 25 patients Two patients died from head injuries overall mortality 28 but there were no bleedingrelated deaths
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