[Treatment of Torode and Zieg type IV unstable pelvic fractures in children]

Abstract

Introduction: Pelvic fractures are infrequent in pediatric patients; they account for 1% of hospital admissions. Acetabular fractures are still more infrequent, but when they are associated, they are life threatening. To distinguish pelvic fractures in children from those in adults, one first needs to know their anatomical differences. The magnitude of the trauma can usually cause injuries in other organs and systems, including the abdominal organs, the genitourinary system, vascular and nerve injuries, etc., as well as long bone, spinal and chest fractures. These injuries may be life threatening and must be treated before the pelvic fracture is addressed.

Objective: To show the results obtained from the surgical treatment of Torode and Zieg type IV pelvic fractures.

Methods: This is a retrospective, observational, longitudinal, descriptive study of 26 patients with Torode and Zieg type IV unstable pelvic fractures during a two-year period.

Results: The age group 14-16 years was the most affected one, with 83.3% of the fractures, followed by the 12-14 years group with 8.33% and the group under this age with 8.33%. The most frequent mechanism of injury was trauma resulting from being run over, with 41.66%, car crash with 37.5%, and falls from a height with 20.83%; 37.5% of patients were polytraumatized and required intensive care; the mortality rate in the study was 7.69%.

Conclusions: According to the results and the patient assessment, we propose that unstable pelvic fractures be managed surgically. The mechanism of injury observed in these patients was not lateral compression, as the literature states, but rather a combined mechanism.