IS POSTERIOR-ONLY RIGID FIXATION AN EFFICIENT OPTION FOR THE TREATMENT OF UNSTABLE LATERAL COMPRESSION PEDIATRIC PELVIC FRACTURES?

Abstract

Background: Pediatric pelvic fractures (PPF) are rare injuries and usually resulted from high-energy mechanisms. Unstable lateral compression fractures may leave permanent deformity with pelvic asymmetry . The purpose of this study was to evaluate the safety and efficacy of rigid posterior fixation for treatment of unstable lateral compression pelvic fractures in children. Methods: A retrospective case series of 13 patients with unstable lateral compression pelvic fractures. All cases were treated in a university hospital between January 2013 and May 2020. Inclusion criteria were: all patients under 16 years old, hemodynamically stable and who were treated posteriorly using rigid posterior fixation with a minimum follow-up of 12 months. Assessment was done clinically utilizing Majeed score and radiologically utilizing Matta score. Results: There were 8 boys and 5 girls with a mean age of 9.5 ± 4 years. There were 8 children with an immature pelvis. The most common causes of injury were motor car accident (61.5%). The interval from injury to surgery was 2-11 days with a mean of 6 ± 2 days. The mean intraoperative time was 81.9 ± 18.3 minutes with a mean operative blood loss of 113.9 ± 48 ml. According to the Matta and Tornetta score; the reduction was rated excellent in 10 patients and good in 3 patients. According to the Majeed score, the outcome was rated excellent in 11 patients and good in 2 patients. Conclusion: Posterior-only rigid fixation by interfragmentary intrailiac screws and plates is a safe and effective method for treatment of unstable lateral compression fractures in children.