The screening pelvic radiograph in pediatric trauma

Background. Pelvic radiographs are routinely obtained in adult trauma to op timise early management. In adults, pelvic fractures are associated with hi gh early transfusion requirement, high injury severity scores and an increa sed incidence of other abdominal and thoracic injuries. It is unclear wheth er this holds true in children. Objective. To determine whether the screening pelvic radiograph is necessar y in paediatric trauma. Materials and methods. The notes of all patients who presented after trauma to the Starship Children's Hospital and were triaged to the resuscitation room during 1997 were reviewed. Results of initial radiography were obtaine d and correlated with later imaging. Results. Our review of 444 injured children seen over a period of 1 year re vealed that of 347 children who had screening pelvic radiographs, only 1 ha d a pelvic fracture. The fracture in this child was clinically apparent and required no specific treatment. Conclusions. The presence of a pel vic fracture is rare in injured children . By omitting screening pelvic radiographs there are potential benefits, in cluding reduced radiation exposure to children and cost savings. Uninterpre table or abnormal clinical examination or haematuria requires further inves tigation, but routine screening for pelvic fracture is unnecessary.