A STUDY ON SKELETALLY IMMATURE UNSTABLE PELVIC FRACTURES IN CHILDREN
Authors: Gupta Dr. Rakesh Kumar , Singh Dr. Mohkam 
Published: November 2019

Introduction: Out of all factures the pelvic facture showed relatively less which account for 3%. In children Pelvic fractures are relatively rare as less than 0.2% of all paediatric fractures and 1-5% of admissions to tertiary children’s health centre. Pelvis is a structure like a basin shaped bony which supports the spinal column and protects the abdominal organs. It may be facture due to high energy forces such as fall from a height or motor vehicle crash.  Incident of pelvic fracture is increasing and these are associated with a high mortality rate of 25%. There was relatively low rate of occurrence of facture of pelvic injuries that associated with high levels of morbidity and mortality. According to the studied of the post-mortem examined only in children 66 deaths caused by trauma that showing pelvic fracture and severe bleeding to be the cause of death in 42% of the cases. In the case of adult in cases of unstable pelvic fractures retroperitoneal bleeding is the worst complication. When involving emergency situation cases with hemodynamic instability immediate treatment must be conducted using an external fixation, though it is only for temporarily to prioritise controlling the bleeding and saving the patient’s life.

Aim: The main objective of this study is to study the surgical treatment for unstable pelvic fractures in children and stabilisation on basic primary care provided at an emergency service.

Material and methods: In this study total 10 children patients were included who had suffered unstable fractures of the pelvic ring. From all the patients detail clinical history were taken with analysis of the pre and postoperative radiographs by presence of the triradiate cartilage of the iliac. This study was based on radiographic quantification and the outcome of the residual pelvic and after the surgery treatment using the method of Keshishyan et al[i] for comparison of pre and post operative findings.

Result: In this study unstable fractures of the pelvic ring evaluated where female were 7 and male were 3 with the ration 7: 3. The ranges were 2 to 13 years with the mean age 7.2 years old. For all the patients operation was done on an average of 12.3 days after the facture. The maximum cases the initial traumas were due to the run over followed by motorcycle accident and fall from height respectively.  The injuries of the pelvis joint were divided inti anterior and posterior.  Symphysis disjucction of the pubic facture were present in maximum with the facture of two rami and facture of four rami respectively. In five of the cases Sacroiliac dislocation correspond to posterior lesion were seen. Unilateral fractures of the posterior ilium were also seen whereas unilateral anterior opening of the sacroiliac joint was also present.

Conclusion: In children facture of pelvic ring is rare and an indication for surgical treatment is unusual.  Their concerns relate  to  the  complications  encountered that in  leg  length  and  residual  pain in  the  sacroiliac  joint. Hence for the justification, this study finding provides justifies the option of surgical treatment for reduction and correction of pelvic deformities, of the pelvic ring at an early stage, at the time of the injury.

Keywords: children, unstable pelvic facture, pelvic ring, Pelvic asymmetry