I struggled to find PEM resources for my CT3 year, despite the variety of excellent resources out there. I hope this website will help point you in the right direction. I'm not a PEM expert, but am following the guidance CEM have issued (in the form of a syllabus) to put together this page. This page is not endorsed by CEM, and any mistakes are mine.

Please comment with corrections, additions and further suggestions.

All the information here is collected from the internet, and it might be out of date or inaccurate, so please use your judgement and adhere to your hospital's protocols. If you do notice any errors or omissions please comment so we can put them right!

To navigate, decide whether you want to start with a PMP or a PAP. You can then select which PMP or PAP you want to look at. You will then be taken to the summary page for that PMP, with links expanded topic collections. If you know what topic you want to look at already, click on the link on the right hand side.

Monday, 7 October 2013

Pelvic Trauma in Children

So the syllabus for Major Paediatric Trauma says "Pelvic fractures: understand the common fracture patterns". A search of google foam, and all my text books hardly ever mention pelvic fractures in children - so I can only deduce that they are not very common. My research did enable me to find a very good set of guidelines for major trauma in children - still with minimal mention of pelvic trauma!

It is mentioned that the skeleton of a child is incompletely calcified, contains multiple active growth centers and is more resilient than that of an adult. It doesn't absorb the the kinetic forces allowing significant force to be transmitted to underlying organs. This is why children are more likely to have greenstick fractures (in long bones) and epiphyseal injuries (Salter Harris). Despite this, x-rays are recommended, as clinical examination is unreliable in children.

From what I've found, I deduce that:
- Pelvic fractures in children are rare
- It is more likely that the pelvis will get squished with no fractures created but significant internal injury.
- If injury does occur it is likely to have similar patterns to injury in adults. 

AAnd my orthopaedic SpR friend agrees - which is helpful!

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