Is Posterior-Only Rigid Fixation an Efficient Option for the Treatment of Unstable Lateral Compression Pediatric Pelvic Fractures?

Background: Pediatric pelvic fractures (PPF) are rare injuries and usually resulted from high-energymechanisms. Unstable lateral compression fractures may leave permanent deformity with pelvic asymmetry.The purpose of this study was to evaluate the safety and efficacy of rigid posterior fixation for treatmentof unstable lateral compression pelvic fractures in children. Methods: A retrospective case series of 13patients with unstable lateral compression pelvic fractures. All cases were treated in a university hospitalbetween January 2013 and May 2020. Inclusion criteria were: all patients under 16 years old, hemodynamically stable and who were treated posteriorly using rigid posterior fixation with a minimum followup of 12 months. Assessment was done clinically utilizing Majeed score and radiologically utilizing Mattascore. Results: There were 8 boys and 5 girls with a mean age of 9.5 ± 4 years. There were 8 childrenwith an immature pelvis. The most common causes of injury were motor car accident (61.5%). The intervalfrom injury to surgery was 2-11 days with a mean of 6 ± 2 days. The mean intraoperative time was 81.9 ±18.3 minutes with a mean operative blood loss of 113.9 ± 48 ml. According to the Matta and Tornettascore; the reduction was rated excellent in 10 patients and good in 3 patients. According to the Majeedscore, the outcome was rated excellent in 11 patients and good in 2 patients. Conclusion: Posterior-onlyrigid fixation by interfragmentary intrailiac screws and plates is a safe and effective method for treatmentof unstable lateral compression fractures in children.