A prospective evaluation of the clinical presentation of pediatric pelvic fractures

Background: We sought to describe pediatric, blunt trauma patients with pel vic fracture (PF) and to evaluate pelvis examination sensitivity and specif icity. Methods: We conducted a prospective study of blunt trauma patients at a Lev el I pediatric trauma center. A pediatric emergency medicine physician atte mpted to diagnose a PF, solely on the basis of the history and pelvis exami nation, Patients with blunt trauma but no pelvic fracture (NPF) were used a s controls. Results:We enrolled 140 patients (16 PF, 124 NPF), and no significant diffe rences were found regarding median age, gender, injury mechanism, acuity, a nd medical outcome, Approximately 25% of PF patients had iliac-wing fractur es; 37%, single pelvic ring; 25%, double pelvic ring; and 13%, acetabular f ractures. Eleven patients with PP had an abnormal pelvis examination (69% s ensitivity), compared with six NPF patients (95% specificity, negative pred ictive value 0.91). Conclusion: Pediatric patients with PF have low mortality and few complex f ractures. The pelvis examination appears to have both high specificity and negative predictive value.