scholarly journals Malgaigne Pelvic Fractures in Children- an unusual unstable fracture pattern of pelvic fractures

Cureus ◽  
2012 ◽  
Author(s):  
Sharat Agarwal ◽  
Mohd. Nasim Akhtar
Keyword(s):  
Fracture Pattern ◽  
Pelvic Fractures ◽  
Unstable Fracture ◽  
Fractures In Children

scholarly journals Application of Pelvic Circumferential Compression Devices in Pelvic Ring Fractures—Are Guidelines Followed in Daily Practice?

2021 ◽  
Vol 10 (6) ◽  
pp. 1297
Author(s):  
Valerie Kuner ◽  
Nicole van Veelen ◽  
Stephanie Studer ◽  
Bryan Van de Wall ◽  
Jürgen Fornaro ◽  
...  
Keyword(s):  
Clinical Education ◽  
Trauma Center ◽  
Pelvic Ring ◽  
Daily Practice ◽  
Pelvic Trauma ◽  
Fracture Pattern ◽  
Pelvic Fractures ◽  
Unstable Fracture ◽  
Associated Injuries ◽  
Resuscitation Room

Early administration of a pelvic circumferential compression device (PCCD) is recommended for suspected pelvic trauma. This study was conducted to evaluate the prevalence of PCCD in patients with pelvic fractures assigned to the resuscitation room (RR) of a Level I trauma center. Furthermore, correct application of the PCCD as well as associated injuries with potential clinical sequelae were assessed. All patients with pelvic fractures assigned to the RR of a level one trauma center between 2016 and 2017 were evaluated retrospectively. Presence and position of the PCCD on the initial trauma scan were assessed and rated. Associated injuries with potential adverse effects on clinical outcome were analysed. Seventy-seven patients were included, of which 26 (34%) had a PCCD in place. Eighteen (23%) patients had an unstable fracture pattern of whom ten (56%) had received a PCCD. The PCCD was correctly placed in four (15%) cases, acceptable in 12 (46%) and incorrectly in ten (39%). Of all patients with pelvic fractures (n = 77, 100%) treated in the RR, only one third (n = 26, 34%) had a PCCD. In addition, 39% of PCCDs were positioned incorrectly. Of the patients with unstable pelvic fractures (n = 18, 100%), more than half either did not receive any PCCD (n = 8, 44%) or had one which was inadequately positioned (n = 2, 11 %). These results underline that preclinical and clinical education programs on PCCD indication and application should be critically reassessed.

Military experience in the management of pelvic fractures from OIF/OEF

2020 ◽  
pp. bmjmilitary-2020-001469
Author(s):  
William Parker ◽  
R W Despain ◽  
J Bailey ◽  
E Elster ◽  
C J Rodriguez ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Pelvic Fracture ◽  
External Fixator ◽  
Injury Severity ◽  
Fracture Pattern ◽  
Injury Pattern ◽  
Pelvic Fractures ◽  
Vertical Shear ◽  
Treatment Modalities ◽  
Pelvic Binder

IntroductionPelvic fractures are a common occurrence in combat trauma. However, the fracture pattern and management within the most recent conflicts, i.e. Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), have yet to be described, especially in the context of dismounted complex blast injury. Our goal was to identify the incidence, patterns of injury and management of pelvic fractures.MethodsWe conducted a retrospective review on all combat-injured patients who arrived at our military treatment hospital between November 2010 and November 2012. Basic demographics, Young-Burgess fracture pattern classification and treatment strategies were examined.ResultsOf 562 patients identified within the study time period, 14% (81 of 562) were found to have a pelvic fracture. The vast majority (85%) were secondary to an improvised explosive device. The average Injury Severity Score for patients with pelvic fracture was 31±12 and 70% were classified as open. Of the 228 patients with any traumatic lower extremity amputation, 23% had pelvic fractures, while 30% of patients with bilateral above-knee amputations also sustained a pelvic fracture. The most common Young-Burgess injury pattern was anteroposterior compression (APC) (57%), followed by lateral compression (LC) (36%) and vertical shear (VS) (7%). Only 2% (nine of 562) of all patients were recorded as having pelvic binders placed in the prehospital setting. 49% of patients with pelvic fracture required procedural therapy, the most common of which was placement of a pelvic external fixator (34 of 40; 85%), followed by preperitoneal packing (16 of 40; 40%) and angioembolisation (three of 40; 0.75%). 17 (42.5%) patients required combinations of these three treatment modalities, the majority of which were a combination of external fixator and preperitoneal packing. The likelihood to need procedural therapy was impacted by injury pattern, as 72% of patients with an APC injury, 100% of patients with a VS injury and 25% of patients with an LC injury required procedural therapy.ConclusionsPelvic fractures were common concomitant injuries following blast-induced traumatic lower extremity amputations. APC was the most common pelvic fracture pattern identified. While procedural therapy was frequent, the majority of patients underwent conservative therapy. However, placement of an external fixator was the most frequently used modality. Considering angioembolisation was used in less than 1% of cases, in the forward deployed military environment, management should focus on pelvic external fixation±preperitoneal packing. Finally, prehospital pelvic binder application may be an area for further process improvement.

scholarly journals Epidemiology of pediatric femur fractures in children: the Swedish Fracture Register

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Zandra Engström ◽  
Olof Wolf ◽  
Yasmin D. Hailer
Keyword(s):  
Surgical Treatment ◽  
Traffic Accidents ◽  
Age Distribution ◽  
Fracture Pattern ◽  
Older Children ◽  
Femur Fractures ◽  
Fractures In Children ◽  
Fracture Register ◽  
Lower Ratio ◽  
The Relationship

Abstract Background Although femur fractures in children are rare, they are the most common fractures in need of hospitalization. We sought to describe the epidemiology and treatment of pediatric femur fractures recorded in the Swedish Fracture Register (SFR). We also studied the relationship between femur fractures, age, sex, fracture pattern, injury mechanism, seasonal variation and treatment. Methods This nationwide observational register study was based on the pediatric part of the SFR. We included all patients < 16 years of age who were registered in the SFR from 2015 to 2018. Results Of the 709 femur fractures, 454 (64%) occurred in boys. Sixty-two of these fractures were proximal (9%), 453 shaft (64%) and 194 distal (27%). A bimodal age distribution peak was observed in boys aged 2–3 and 16–19 years. In contrast, the age distribution among girls was evenly distributed. Younger children were mainly injured by a fall, whereas older children sustained their fracture because of traffic accidents. Non-surgical treatment prevailed among younger children; however, prevalence of surgical treatment increased with age. Conclusions We found a lower ratio between boys and girls (1.8:1) compared to earlier studies. The bimodal age distribution was seen only in boys. Falls were the most common injury in younger children, whereas traffic-related accidents were the most common in adolescents. With age, there was a corresponding increase in surgical treatment.

Traumatic pelvic fractures in children and adolescents

2017 ◽  
Vol 26 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Christopher J. DeFrancesco ◽  
Wudbhav N. Sankar
Keyword(s):  
Children And Adolescents ◽  
Pelvic Fractures ◽  
Fractures In Children

Pelvic Fractures in Children

2005 ◽  
Vol 25 (5) ◽  
pp. 581-587 ◽  
Author(s):  
Michael G Vitale ◽  
Michael W Kessler ◽  
Julie C Choe ◽  
Matthew W Hwang ◽  
Vernon T Tolo ◽  
...  
Keyword(s):  
Pelvic Fractures ◽  
Fractures In Children

scholarly journals Protocol for a systematic review of the incidence of infection in operative vs non-operative management of Seymour fractures in children and adolescents

2020 ◽  
Author(s):  
Ailbhe Lynda Kiely ◽  
Grant Switzer Nolan ◽  
Lilli Cooper
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Children And Adolescents ◽  
Grey Literature ◽  
Operative Management ◽  
Fracture Pattern ◽  
Cochrane Library ◽  
Non Union ◽  
Fractures In Children ◽  
Non Operative Management

Abstract Background Seymour fractures are open, displaced juxta-epiphyseal fractures of the distal phalanx, with an overlying nail bed laceration that occur in children and adolescents with an open physis. This fracture occurs rarely, but its potential consequences are clinically significant. Due to anatomical particulars and proximity to the growth plate, this open fracture may result in soft tissue infection and osteomyelitis, leading to growth arrest and persistent mallet deformity. At present, there is no consensus as to the optimal management of Seymour fractures. The objective of this study will be to systematically evaluate the existing evidence to establish whether operative or non-operative management of Seymore fractures is associated with a lower incidence of infection. Methods We designed and registered a study protocol for a systematic review of comparative and observational studies. A comprehensive literature search will be conducted (from 1966 to present) in MEDLINE, EMBASE, CINAHL, Cochrane Library and Google Scholar databases. Grey literature will be identified through searching Open Grey and dissertation databases using an exhaustive search strategy. All clinical studies examining the management of Seymour fractures in children & adolescents will be included, comparing operative and non-operative groups. Operative management will be defined as formal washout and soft tissue debridement prior to reduction, whether in the emergency department or operating theatre. Non-operative management refers to washout without surgical debridement. Primary outcome measures will be the incidence of superficial and deep infection. Secondary outcomes will include adverse events such mal-union, non-union, need for re-operation, physeal disturbance, nail dystrophy/atrophy. Two independent reviewers will screen all citations, full-text articles, and abstract data. Conflicts will be resolved through discussion. The study methodological quality (or bias) will be appraised using an appropriate tool. A narrative synthesis will be performed and if two or more studies with comparable design and reporting the same outcome are identified, data will be pooled for comparative analysis. Discussion This review will provide robust evidence for the management of Seymour fractures, based on a cumulation of existing studies. Due to the rarity of this fracture pattern, included studies are expected to be mainly observational and prone to bias; however, there is value in summarising the evidence, assessing its risk of bias and performing meta-analysis where possible to guide clinicians. Registration PROSPERO CRD42020153726

scholarly journals Results of surgical treatment of unstable pelvic fractures in children

Injury Extra ◽  
2007 ◽  
Vol 38 (1) ◽  
pp. 19-20
Author(s):  
R. Trehan ◽  
S. Kumar ◽  
M. Bircher
Keyword(s):  
Surgical Treatment ◽  
Pelvic Fractures ◽  
Fractures In Children
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