Pelvic Trauma

Amita A. Desai; Katherine W. Gonzalez; David Juang

doi:10.1055/s-0035-1554988

Journal of Pediatric Intensive Care, Table of Contents

J Pediatr Intensive Care 2015; 04(01): 040-046
DOI: 10.1055/s-0035-1554988

Review Article

Georg Thieme Verlag KG Stuttgart · New York

Pelvic Trauma

Authors

Amita A. Desai

¹Department of Surgery, Children's Mercy Hospital and Clinics, Kansas City, Missouri, United States
Katherine W. Gonzalez

¹Department of Surgery, Children's Mercy Hospital and Clinics, Kansas City, Missouri, United States
David Juang

¹Department of Surgery, Children's Mercy Hospital and Clinics, Kansas City, Missouri, United States

Abstract

The leading cause of death in the pediatric population is trauma, of which pelvic injuries make up a very small percentage. Trauma to the pelvis can result in multiple injuries to the bony pelvis, rectum, bladder, and or the urethra. Although mortality in the pediatric population is typically secondary to associated injuries, pelvic hemorrhage can be a life-threatening event. The management of patients with complex pelvic injuries requires a multidisciplinary approach in order to achieve the best possible outcomes.

Keywords

pediatric - trauma - pelvis

Full Text

References

References
1 Bond SJ, Gotschall CS, Eichelberger MR. Predictors of abdominal injury in children with pelvic fracture. J Trauma 1991; 31 (8) 1169-1173
2 McIntyre Jr RC, Bensard DD, Moore EE, Chambers J, Moore FA. Pelvic fracture geometry predicts risk of life-threatening hemorrhage in children. J Trauma 1993; 35 (3) 423-429
3 Demetriades D, Karaiskakis M, Velmahos GC, Alo K, Murray J, Chan L. Pelvic fractures in pediatric and adult trauma patients: are they different injuries?. J Trauma 2003; 54 (6) 1146-1151 , discussion 1151
4 Pascarella R, Bettuzzi C, Digennaro V. Surgical treatment for pelvic ring fractures in pediatric and adolescence age. Musculoskelet Surg 2013; 97 (3) 217-222
5 Ismail N, Bellemare JF, Mollitt DL, DiScala C, Koeppel B, Tepas III JJ. Death from pelvic fracture: children are different. J Pediatr Surg 1996; 31 (1) 82-85
6 Reichard SA, Helikson MA, Shorter N, White Jr RI, Shemeta DW, Haller Jr JA. Pelvic fractures in children—review of 120 patients with a new look at general management. J Pediatr Surg 1980; 15 (6) 727-734
7 Velmahos GC. Pelvis. In: Mattox KL, Moore EE, Feliciano DV, , eds. Trauma. 7th ed. New York, NY: McGraw Hill; 2013: 655-668
8 Wisner DH, Galante JM, Dolich MO, Hoyt DB. Abdominal trauma. In: Mulholland MW, Lillemoe KD, Doherty GM, Maier RV, Simeone DM, Upchurch Jr GR, , eds. Greenfield's surgery. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins, Wolters Kluwer business; 2011: 385-404
9 Gänsslen A, Hildebrand F, Heidari N, Weinberg AM. Pelvic ring injuries in children. Part I: Epidemiology and primary evaluation. A review of the literature. Acta Chir Orthop Traumatol Cech 2012; 79 (6) 493-498
10 Holden CP, Holman J, Herman MJ. Pediatric pelvic fractures. J Am Acad Orthop Surg 2007; 15 (3) 172-177
11 Torode I, Zieg D. Pelvic fractures in children. J Pediatr Orthop 1985; 5 (1) 76-84
12 Shore BJ, Palmer CS, Bevin C, Johnson MB, Torode IP. Pediatric pelvic fracture: a modification of a preexisting classification. J Pediatr Orthop 2012; 32 (2) 162-168
13 Burgess AR, Eastridge BJ, Young JW , et al. Pelvic ring disruptions: effective classification system and treatment protocols. J Trauma 1990; 30 (7) 848-856
14 Manson T, O'Toole RV, Whitney A, Duggan B, Sciadini M, Nascone J. Young-Burgess classification of pelvic ring fractures: does it predict mortality, transfusion requirements, and non-orthopaedic injuries?. J Orthop Trauma 2010; 24 (10) 603-609
15 Baqué P, Trojani C, Delotte J , et al. Anatomical consequences of “open-book” pelvic ring disruption: a cadaver experimental study. Surg Radiol Anat 2005; 27 (6) 487-490
16 Bottlang M, Simpson T, Sigg J, Krieg JC, Madey SM, Long WB. Noninvasive reduction of open-book pelvic fractures by circumferential compression. J Orthop Trauma 2002; 16 (6) 367-373
17 Jowett AJ, Bowyer GW. Pressure characteristics of pelvic binders. Injury 2007; 38 (1) 118-121
18 Ertel W, Keel M, Eid K, Platz A, Trentz O. Control of severe hemorrhage using C-clamp and pelvic packing in multiply injured patients with pelvic ring disruption. J Orthop Trauma 2001; 15 (7) 468-474
19 Abrassart S, Stern R, Peter R. Unstable pelvic ring injury with hemodynamic instability: what seems the best procedure choice and sequence in the initial management?. Orthop Traumatol Surg Res 2013; 99 (2) 175-182
20 Prasarn ML, Horodyski M, Conrad B , et al. Comparison of external fixation versus the trauma pelvic orthotic device on unstable pelvic injuries: a cadaveric study of stability. J Trauma Acute Care Surg 2012; 72 (6) 1671-1675
21 Tile M. The management of unstable injuries of the pelvic ring. J Bone Joint Surg Br 1999; 81 (6) 941-943
22 Cullinane DC, Schiller HJ, Zielinski MD , et al. Eastern Association for the Surgery of Trauma practice management guidelines for hemorrhage in pelvic fracture—update and systematic review. J Trauma 2011; 71 (6) 1850-1868
23 Verbeek DO, Zijlstra IA, van der Leij C, Ponsen KJ, van Delden OM, Goslings JC. Management of pelvic ring fracture patients with a pelvic “blush” on early computed tomography. J Trauma Acute Care Surg 2014; 76 (2) 374-379
24 Vo NJ, Althoen M, Hippe DS, Prabhu SJ, Valji K, Padia SA. Pediatric abdominal and pelvic trauma: safety and efficacy of arterial embolization. J Vasc Interv Radiol 2014; 25 (2) 215-220
25 Tanizaki S, Maeda S, Matano H, Sera M, Nagai H, Ishida H. Time to pelvic embolization for hemodynamically unstable pelvic fractures may affect the survival for delays up to 60 min. Injury 2014; 45 (4) 738-741
26 Cothren CC, Osborn PM, Moore EE, Morgan SJ, Johnson JL, Smith WR. Preperitonal pelvic packing for hemodynamically unstable pelvic fractures: a paradigm shift. J Trauma 2007; 62 (4) 834-839 , discussion 839–842
27 Tötterman A, Madsen JE, Skaga NO, Røise O. Extraperitoneal pelvic packing: a salvage procedure to control massive traumatic pelvic hemorrhage. J Trauma 2007; 62 (4) 843-852
28 Demetriades D, Karaiskakis M, Toutouzas K, Alo K, Velmahos G, Chan L. Pelvic fractures: epidemiology and predictors of associated abdominal injuries and outcomes. J Am Coll Surg 2002; 195 (1) 1-10
29 Demetriades D, Inaba K. Colon and rectal trauma. In: Mattox KL, Moore EE, Feliciano DV, , eds. Trauma. 7th ed. New York, NY: McGraw Hill; 2013: 620-631
30 Bala M, Rivkind AI, Zamir G , et al. Abdominal trauma after terrorist bombing attacks exhibits a unique pattern of injury. Ann Surg 2008; 248 (2) 303-309
31 Anderson SW, Soto JA. Anorectal trauma: the use of computed tomography scan in diagnosis. Semin Ultrasound CT MR 2008; 29 (6) 472-482
32 Burch JM, Feliciano DV, Mattox KL. Colostomy and drainage for civilian rectal injuries: is that all?. Ann Surg 1989; 209 (5) 600-610 , discussion 610–611
33 Ivatury RR, Licata J, Gunduz Y, Rao P, Stahl WM. Management options in penetrating rectal injuries. Am Surg 1991; 57 (1) 50-55
34 Velmahos GC, Gomez H, Falabella A, Demetriades D. Operative management of civilian rectal gunshot wounds: simpler is better. World J Surg 2000; 24 (1) 114-118
35 Levy RD, Strauss P, Aladgem D, Degiannis E, Boffard KD, Saadia R. Extraperitoneal rectal gunshot injuries. J Trauma 1995; 38 (2) 273-277
36 Navsaria PH, Edu S, Nicol AJ. Civilian extraperitoneal rectal gunshot wounds: surgical management made simpler. World J Surg 2007; 31 (6) 1345-1351
37 Zmora O, Mahajna A, Bar-Zakai B , et al. Colon and rectal surgery without mechanical bowel preparation: a randomized prospective trial. Ann Surg 2003; 237 (3) 363-367
38 Thomas DD, Levison MA, Dykstra BJ, Bender JS. Management of rectal injuries. Dogma versus practice. Am Surg 1990; 56 (8) 507-510
39 Levine JH, Longo WE, Pruitt C, Mazuski JE, Shapiro MJ, Durham RM. Management of selected rectal injuries by primary repair. Am J Surg 1996; 172 (5) 575-578 , discussion 578–579
40 Ameh EA. Anorectal injuries in children. Pediatr Surg Int 2000; 16 (5-6) 388-391
41 Haut ER, Nance ML, Keller MS , et al. Management of penetrating colon and rectal injuries in the pediatric patient. Dis Colon Rectum 2004; 47 (9) 1526-1532
42 Bonnard A, Zamakhshary M, Wales PW. Outcomes and management of rectal injuries in children. Pediatr Surg Int 2007; 23 (11) 1071-1076
43 Hooker KD, DiPiro JT, Wynn JJ. Aminoglycoside combinations versus beta-lactams alone for penetrating abdominal trauma: a meta-analysis. J Trauma 1991; 31 (8) 1155-1160
44 Sims EH, Thadepalli H, Ganesan K, Mandal AK. How many antibiotics are necessary to treat abdominal trauma victims?. Am Surg 1997; 63 (6) 525-535
45 Cornwell III EE, Dougherty WR, Berne TV , et al. Duration of antibiotic prophylaxis in high-risk patients with penetrating abdominal trauma: a prospective randomized trial. J Gastrointest Surg 1999; 3 (6) 648-653
46 Coburn M. Geniourinary trauma. In: Mattox KL, Moore EE, Feliciano DV, , eds. Trauma. 7th ed. New York, NY: McGraw Hill; 2013: 669-708
47 Cass AS. The multiple injured patient with bladder trauma. J Trauma 1984; 24 (8) 731-734
48 Spiguel L, Glynn L, Liu D, Statter M. Pediatric pelvic fractures: a marker for injury severity. Am Surg 2006; 72 (6) 481-484
49 Smith III TG, Wessels H. Genitourinary trauma. In: Mulholland MW, Lillemoe KD, Doherty GM, Maier RV, Simeone DM, Upchurch Jr GR, , eds. Greenfield's surgery. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins, Wolters Kluwer business; 2011: 405-413
50 Carroll PR, McAninch JW. Major bladder trauma: mechanisms of injury and a unified method of diagnosis and repair. J Urol 1984; 132 (2) 254-257
51 Carroll PR, McAninch JW. Major bladder trauma: the accuracy of cystography. J Urol 1983; 130 (5) 887-888
52 Hayes EE, Sandler CM, Corriere Jr JN. Management of the ruptured bladder secondary to blunt abdominal trauma. J Urol 1983; 129 (5) 946-948
53 Corriere Jr JN, Sandler CM. Management of the ruptured bladder: seven years of experience with 111 cases. J Trauma 1986; 26 (9) 830-833
54 Basta AM, Blackmore CC, Wessells H. Predicting urethral injury from pelvic fracture patterns in male patients with blunt trauma. J Urol 2007; 177 (2) 571-575
55 Vanni AJ, Wessels H, Injuries to the urogenital tract. In: Ashley SW. , ed. Online; Scientific American Surgery Decker Intellectual Properties: 2014. Available at: http://www.sciamsurgery.com/sciamsurgery/ . Accessed September 29, 2014.
56 Hadjizacharia P, Inaba K, Teixeira PG, Kokorowski P, Demetriades D, Best C. Evaluation of immediate endoscopic realignment as a treatment modality for traumatic urethral injuries. J Trauma 2008; 64 (6) 1443-1449 , discussion 1449–1450