TREATMENT RESULTS AFTER COMPLEX PELVIC TR AUMA IN CHILDREN

Between 1972 and 1994 21 children up to 14 years old sustained complex pelvic trauma treated at the Trauma Department of the Hannover Medica l School, Sixteen of the 17 survivors were followed at an average of 8 .9 years, In 8 patients operative treatment of the disrupted pelvic ri ng (external or internal fixation) was performed; in 8 patients the tr eatment was conservative, At follow-up 9 patients (56%) were pain-free ; 4 reported slight, 2 moderate and one patient severe pain (at rest). There were no neurological deficits, Four patients had disturbed mict uria, and 1 had bowel incontinence. Radiological evaluation showed ana tomic reconstruction of the pelvic ring in 9 cases (56%). Residual max imum displacement of 12 mm was detected in 2 patients. In 3 cases oste oarthritis or ancylosis of the SI joint was present. In 3 cases a clin ically not disturbing heterotopic ossification was found, Another 2 ca ses had ossifications of the pubic symphyses, A post-traumatic acetabu lar dysplasia was detected in 2 cases; a hypoplasia of the hemipelvis was seen in 3 patients. In a retrospective analysis of the primary rad iographs, 13 pelvic lesions were not detected during the primary clini cal course (sacral fracures, lesions of the triradiate cartilage), Des pite this finding the pelvic outcome was rated good and excellent in 1 0 patients (63%), moderate in 1 patient (hypoplasia of the hemipelvis, and poor in 5 patients (31%) with severe pain or urogenital disturban cies. The maximum ratings in social reintegration was given to 9 patie nts, a medium rating to 7 patients. All patients were socially integra ted.