Pelvic fractures and associated injuries in children

Background: Pelvic fractures occur uncommonly in children. Despite serious sequelae, they have been infrequently reviewed. Methods: We conducted a retrospective review of admissions to our institution from January 1983 to December 2000. Results: One hundred twenty children with pelvic fractures were identified. Median age was 9 years (range, 1-16 years) and 66% (n = 80) were boys. Pedestrian-motor vehicle injury accounted for 68% (n = 82) of cases. Associated injuries were present in 78% (n = 94). Management of the pelvic fracture was nonoperative in 113 (94%). Thirty-two children (27%) required surgery for associated injuries. Complications during admission occurred in 28% (n = 34). Five children died as a result of their injuries. With a mean follow-up of 36 months (range, 7-156 months), 27% (n = 32) of children suffered an adverse outcome, including neurologic dysfunction and leg-length discrepancies. Conclusion: The majority of pelvic fractures in children may be satisfactorily treated nonoperatively. Operative interventions were more frequently required for associated injuries. Long-term review is indicated because of delayed complications in children that are continuing to grow and develop.