Pelvic fractures in severely injured children: results from the TraumaRegister DGU®

Abstract: Injuries in the pelvic region in children and adolescents are very rare and often associated with a high energy trauma. Aim of this prospective multicenter study was, by analyzing the data from the TraumaRegister Deutsche Gesellschaft für Unfallchirurgie (TRDGU), to evaluate any correlation between the severity of pelvic fractures and resulting mortality in different age groups.

These study findings are based on a large pool of data retrieved from the prospectively-setup pelvic trauma registry established by the German Trauma Society (DGU) and the German Section of the Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF) International in 1991. The registry provides data on all patients suffering pelvic fractures within a 14-year time frame at any 1 of the 23 level 1 trauma centers contributing to the registry. The analysis covers 4 age groups ranging from 0 to 17 years, covering different factors regarding pelvic fractures and their treatment.

We identified a total of 9684 patients including 1433 pelvic fractures in children aged _17 years. Those patients were divided into 4 subgroups according to the patients’ age (groups A–D) and according to the fracture severity (group 1= Abbreviated Injury Scale (AIS) score pelvis _2, and group 2=AIS pelvis ≥3). The mortality in group 1 was 8.8% with a RISC (Revised Injury Severity Score) II of 8.6%, standardmortality rate (SMR) of1.02 and 7.2%in group 2with anRISCII of 9.9%(SMR0.73). Inpelvic facturesof TypeA(Tile classification of pelvic fractures), an SMR of 0.76 was recorded, in Type B fractures the SMR was 0.65, and in Type C fractures 0.79. Severe pelvic injuries (AIS pelvis ≥2) were associated with a higher rate of whole body computer tomograph (CT) scans (1–5 years: 80%, 6–10 years 81.8%, 11–14 years 84.7%, and 15–17 years 85.6%). The rate of pelvic surgery rose with the pelvic injury’s severity (AIS 2: 7.6%, AIS 3: 35%, AIS 4: 65.6%, AIS 5 61.5%).We observed higher rates of preclinical and initial clinical hypotension defined as Riva-Rocci (RR)<90 mmHG) aswell as of preclinical fluid application in all age groups. The presenceof a pelvic injurywas associated with a higher rate of severe abdominal injuries with an AIS of ≥3 (25.1% vs. 14.6%) and of severe thorax injuries with an AIS≥3 (43.6% vs. 28.6%).

We have been able to analyze an enormous number of pelvic fractures in children and adolescents including different age groups by relying on data from the TR-DGU. Mortality seems to be associated with the severity of the pelvic injury, but is lower than the RISC II score’s prognosis

Angaben zum Objekt

• Standort: Deutsche Nationalbibliothek Frankfurt am Main
• Umfang: Online-Ressource
• Sprache: Englisch

Klassifikation und Themen

• Schlagwort: Beckenbruch ; Kind

Beteiligte, Orts- und Zeitangaben

• Ereignis: Veröffentlichung
• (wo): Freiburg
• (wer): Universität
• (wann): 2018
• Urheber: Zwingmann, Jörn ; Lefering, Rolf ; Maier, Dirk ; Bode, Lisa ; Eberbach, Helge Andreas ; Neumann, Mirjam Victoria ; Strohm, Peter Christian ; Südkamp, Norbert P. ; Hammer, Thorsten

Weitere Informationen

• DOI: 10.1097/MD.0000000000011955
• URN: urn:nbn:de:bsz:25-freidok-165095
• Rechteinformation: Kein Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Letzte Aktualisierung: 25.03.2025, 13:52 MEZ