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Severe pelvic fracture-related bleeding in pediatric patients: does it occur Full Text
European Journal of Trauma and Emergency Surgery, 08/18/2011
Tuovinen H et al. – The authors conclude that life–threatening bleeding from pelvic or acetabular fractures in pediatric patients is rare (2.8%), and does not contribute to the overall mortality.
Methods- The authors identified retrospectively all pediatric pelvic fractures (ring and acetabulum) treated at Helsinki University Central Hospital during a 10–year period (1998–2007).
- Stable A–type fractures (fractures not involving the pelvic ring) were excluded.
- All available pre– and in–hospital medical records were reviewed.
- The collected data consisted of patient characteristics, mechanisms of injury, vital signs, laboratory tests, care given, other injuries diagnosed, and the 30–day survival rate.
- There were 71 (40 males) pediatric patients (median age 14, range 1–16 years) with unstable pelvic fractures; 66 pelvic ring and 5 acetabulum fractures.
- The most common mechanism of injury was traffic accident (69%).
- Four patients had life–threatening bleeding.
- All had fracture of a mature pelvic ring, but the source of massive bleeding was pelvic ring fracture in only two patients (2.8% of all patients).
- No acetabulum fracture–related major pelvic bleeding was observed.
- One patient (age 16 years) required emergency surgery and angioembolization for pelvic bleeding.
- No life–threatening pelvic bleeding was seen among patients with immature bony pelvis.
- Pelvic ring fractures were surgically treated in 25 patients.
- Two patients died from head injuries (overall mortality 2.8%), but there were no bleeding–related deaths.