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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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