Document Type

Conference Proceeding

Publication Date

4-10-2025

Abstract

OBJECTIVE: The association between pelvic trauma and urogenital injuries in adult patients is well established, whereas literature concerning pediatric patients is sparse. The purpose of this study was to determine the association between pelvic trauma and urogenital injuries in the pediatric population including incidence, and trends in injury modality, treatment patterns, imaging, and outcome. METHODS: This was a single-center, retrospective chart review. Patients aged 0-16 years admitted for pelvic fracture, pelvic dislocation, proximal femur fracture, and injury of urinary and pelvic organs over a 15-year period were included. Primary outcomes included fracture diagnosis, urogenital injury diagnosis, treatment modalities, and mechanism of injury. Secondary outcomes included patient demographics, length of hospital stay, length of ICU stay, imaging modalities, foley placement, and other associated injuries. Charts for 371 patients were reviewed, and following additional exclusion criteria, data from 303 patients was analyzed using ANOVA and Chi-Square analysis where appropriate. RESULTS: 303 patients were divided into three groups based on primary fracture diagnosis: pelvic ring fracture n = 149 (49.2%), femur fracture n = 128 (42.2%), and acetabular fracture/hip dislocation n = 26 (8.6%). Associated urogenital injuries were classified in the following groups, with injury rates listed in order of pelvic ring fracture patients, femur fracture patients, and acetabular fracture/hip dislocation patients: no associated injury n = 122, 116, 26 (81.9%, 90.6%, 100%), hematuria n = 10, 1, 0 (6.7%, 0.8%, 0.0%), superficial injury n = 5, 1, 0 (3.4%, 0.8%, 0.0%), urethral or bladder injury n = 3, 0, 0 (2.0%, 0.0%, 0.0%), urinary retention or incontinence n = 8, 8, 0 (5.4%, 6.3%, 0.0%), and other n = 1, 2, 0 (0.7%, 1.6%, 0.0%) (p = 0.0690). Treatment of pelvic ring fractures was predominantly non-operative n = 133 (89.3%), whereas treatment of femur fractures (operative n = 73 (57.5%), non-operative n = 53 (41.7%)) and acetabular fractures/hip dislocations (operative n = 11 (42.3%), non-operative n = 15 (57.7%)) was more balanced (p = < .0001). CONCLUSIONS: In contrast to the adult population, there is not a clinically significant association between pelvic trauma and urogenital injuries in pediatric patients. Most pediatric pelvic ring trauma was treated conservatively, without the need for surgery, whereas the adult population more often requires surgical repair.

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Mid-America Orthopaedic Association 42nd Annual Meeting, April 9-13, 2025, San Antonio, TX

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