Limited ilioinguinal approach for unstable pelvic fractures in children aged <3 years

Background: Pelvic fractures in pediatric trauma account for 0.5–1 % of total hospital admissions, whereas acetabular fracture occurs at a rate of one case per 100,000 children; the low presentation rate is due to its unique characteristics. Standardized management for this age group is impossible....

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Main Authors: C. Gonzalez-Cancino, M. Gonzalez
Format: Article
Language:English
Published: Elsevier 2024-08-01
Series:Trauma Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352644024000773
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author C. Gonzalez-Cancino
M. Gonzalez
author_facet C. Gonzalez-Cancino
M. Gonzalez
author_sort C. Gonzalez-Cancino
collection DOAJ
description Background: Pelvic fractures in pediatric trauma account for 0.5–1 % of total hospital admissions, whereas acetabular fracture occurs at a rate of one case per 100,000 children; the low presentation rate is due to its unique characteristics. Standardized management for this age group is impossible. Conservative treatment has been commonly used but surgical correction has gained popularity. The purpose of this study was to report the authors' experience using a limited ilioinguinal approach for unstable pelvic fracture in two toddlers. Methods: Description of case studies. Results: Herein, we describe the treatment of two patients: a male patient struck by a vehicle (aged 1 year and 7 months) and a female patient ejected from a motor vehicle (aged 2 years and 1 month). They sustained an unstable type IV fracture in the modified Torode and Zieg classification. Surgical treatment was performed using a limited ilioinguinal approach, and stabilization was achieved using 3.5-mm reconstruction plate. There were no iatrogenic nerve injuries or infection. The female patient had left hip dislocation 2 months post-surgery and was unfortunately lost to follow-up. The male patient achieved radiological bone union without discrepancy, with no loss of reduction or evidence of pain during the mean follow-up period of 18 months. Conclusion: Pelvic fracture in children is rare. Based on fracture patterns, surgical stabilization may be necessary to prevent major complications in the short, medium, or long term. The limited ilioinguinal approach was proven to be a viable alternative for managing unstable pelvic fracture in children aged <3 years with minimal blood lo and shorter operative time, allowing more anatomical and stable reduction.
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spelling doaj-art-9162ccfc3fa94869a4394b64192de1d32025-08-20T03:20:33ZengElsevierTrauma Case Reports2352-64402024-08-015210105410.1016/j.tcr.2024.101054Limited ilioinguinal approach for unstable pelvic fractures in children aged <3 yearsC. Gonzalez-Cancino0M. Gonzalez1Corresponding author at: Department of Orthopaedic and Traumatology Surgery, Gilberto Gomez Maza Hospital, Libramiento Norte &amp; Boulevard Centenario del Ejercito Mexicano S/N, Las Torres, 29045 Tuxtla Gutiérrez, Chiapas, Mexico.; Department of Orthopaedic and Traumatology Surgery, Gilberto Gomez Maza Hospital, Tuxtla Gutiérrez, Chiapas, MexicoDepartment of Orthopaedic and Traumatology Surgery, Gilberto Gomez Maza Hospital, Tuxtla Gutiérrez, Chiapas, MexicoBackground: Pelvic fractures in pediatric trauma account for 0.5–1 % of total hospital admissions, whereas acetabular fracture occurs at a rate of one case per 100,000 children; the low presentation rate is due to its unique characteristics. Standardized management for this age group is impossible. Conservative treatment has been commonly used but surgical correction has gained popularity. The purpose of this study was to report the authors' experience using a limited ilioinguinal approach for unstable pelvic fracture in two toddlers. Methods: Description of case studies. Results: Herein, we describe the treatment of two patients: a male patient struck by a vehicle (aged 1 year and 7 months) and a female patient ejected from a motor vehicle (aged 2 years and 1 month). They sustained an unstable type IV fracture in the modified Torode and Zieg classification. Surgical treatment was performed using a limited ilioinguinal approach, and stabilization was achieved using 3.5-mm reconstruction plate. There were no iatrogenic nerve injuries or infection. The female patient had left hip dislocation 2 months post-surgery and was unfortunately lost to follow-up. The male patient achieved radiological bone union without discrepancy, with no loss of reduction or evidence of pain during the mean follow-up period of 18 months. Conclusion: Pelvic fracture in children is rare. Based on fracture patterns, surgical stabilization may be necessary to prevent major complications in the short, medium, or long term. The limited ilioinguinal approach was proven to be a viable alternative for managing unstable pelvic fracture in children aged <3 years with minimal blood lo and shorter operative time, allowing more anatomical and stable reduction.http://www.sciencedirect.com/science/article/pii/S2352644024000773PelvicAcetabularFractureChildSurgery
spellingShingle C. Gonzalez-Cancino
M. Gonzalez
Limited ilioinguinal approach for unstable pelvic fractures in children aged <3 years
Trauma Case Reports
Pelvic
Acetabular
Fracture
Child
Surgery
title Limited ilioinguinal approach for unstable pelvic fractures in children aged <3 years
title_full Limited ilioinguinal approach for unstable pelvic fractures in children aged <3 years
title_fullStr Limited ilioinguinal approach for unstable pelvic fractures in children aged <3 years
title_full_unstemmed Limited ilioinguinal approach for unstable pelvic fractures in children aged <3 years
title_short Limited ilioinguinal approach for unstable pelvic fractures in children aged <3 years
title_sort limited ilioinguinal approach for unstable pelvic fractures in children aged 3 years
topic Pelvic
Acetabular
Fracture
Child
Surgery
url http://www.sciencedirect.com/science/article/pii/S2352644024000773
work_keys_str_mv AT cgonzalezcancino limitedilioinguinalapproachforunstablepelvicfracturesinchildrenaged3years
AT mgonzalez limitedilioinguinalapproachforunstablepelvicfracturesinchildrenaged3years