Pelvic ring and acetabulum injuries in children and adolescents

Etiopathogenesis. Fractures of the pelvic ring and acetabulum in children and adolescents are rare injuries. Because of the high flexibility of the not yet completely ossified pelvic skeletal structure, high forces are necessary to cause a fracture. Thus, in children, life-threatening injuries to organs can occur without an obvious osseous lesion. Diagnostics. Because of the large and numerous cartilaginous areas, diagnostic procedures for the paediatric pelvic ring are much more demanding than in adults. Therefore, a relevant number of pelvic fractures in children are diagnosed with delay or not recognized at all. Therapy. The therapeutic procedures for both conservative and operative treatment have to be adapted to the special conditions in the not yet fully developed bone structure. In operative treatment, the consequent protection of the epiphyseal plates is of superior importance. Like in adults, anatomic reduction of acetabular fractures must be aspired when treating paediatric patients. A higher potential of correction of the still developing bone must not be expected in this anatomical region. Outcome. The outcome after pelvic ring and acetabular fractures in children and adolescents in general is good, provided that the injury is diagnosed early and is treated adequately.