Role of computed tomography in the classification and management of pediatric pelvic fractures

In adults, pelvic computed tomography (CT) scanning plays an important role in the treatment of pelvic fractures; however, the role of CT scanning in the management of pediatric pelvic fractures is unclear. The purpose of thi s study was to investigate the efficacy of CT scanning in the management of pelvic fractures in children. One hundred three consecutive patients were identified. All patients underwent anteroposterior plain radiographic evalu ation; CT scans were performed in 62. Three orthopaedic surgeons independen tly reviewed the plain radiographs and determined fracture classification a nd management. Subsequently, each observer was shown corresponding CT scans and again determined classification and management. Interobserver agreemen t was calculated using Kappa statistics. After the addition of CT scans, th e mean changes in classification were nine (15%) and in management two (3%) . Plain radiographs alone reliably predicted the need and type of operative intervention. Kappa statistics demonstrated "excellent" agreement for clas sification and management without and with CT scans. We reliably determined fracture classification and management based on plain radiographs alone.