Display options
Cite
Elnahal WA, Fahmy M, Acharya M. Open complete anterior dislocation of the sacro-iliac joint in a 4-year-old boy: a case report of a rare injury with 5-year follow-up. Strategies Trauma Limb Reconstr. 2017;13(1):51-55doi: 10.1007/s11751-017-0294-6.
Elnahal, W. A., Fahmy, M., & Acharya, M. (2018). Open complete anterior dislocation of the sacro-iliac joint in a 4-year-old boy: a case report of a rare injury with 5-year follow-up. Strategies in trauma and limb reconstruction, 13(1), 51-55. https://doi.org/10.1007/s11751-017-0294-6
Elnahal, Walid A, et al. "Open complete anterior dislocation of the sacro-iliac joint in a 4-year-old boy: a case report of a rare injury with 5-year follow-up." Strategies in trauma and limb reconstruction vol. 13,1 (2018): 51-55. doi: https://doi.org/10.1007/s11751-017-0294-6
Elnahal WA, Fahmy M, Acharya M. Open complete anterior dislocation of the sacro-iliac joint in a 4-year-old boy: a case report of a rare injury with 5-year follow-up. Strategies Trauma Limb Reconstr. 2018 Apr;13(1):51-55. doi: 10.1007/s11751-017-0294-6. Epub 2017 Sep 09. PMID: 28889364; PMCID: PMC5862704.
Copy Download .nbib Format: NLM
Share it on

Strategies Trauma Limb Reconstr. 2018 Apr;13(1):51-55. doi: 10.1007/s11751-017-0294-6. Epub 2017 Sep 09.

Open complete anterior dislocation of the sacro-iliac joint in a 4-year-old boy: a case report of a rare injury with 5-year follow-up.

Strategies in trauma and limb reconstruction

Walid A Elnahal, Mahmoud Fahmy, Mehool Acharya

Affiliations

  1. Trauma and Orthopaedics Department, Faculty of Medicine, Cairo University, Giza, Egypt. [email protected].
  2. Trauma and Orthopaedics Department, Faculty of Medicine, Cairo University, Giza, Egypt.
  3. Trauma and Orthopaedics Department, North Bristol NHS Trust, Bristol, UK.

PMID: 28889364 PMCID: PMC5862704 DOI: 10.1007/s11751-017-0294-6

Abstract

Pelvic fractures are uncommon in children and account for between 0.3 and 7.5% of all pediatric injuries. Open pelvic fractures only account for up to 12.9% of all pediatric pelvic fractures. An unusual case of open complete anterior sacro-iliac joint dislocation in a 4-year-old boy is presented with a long-term follow-up. The multidisciplinary approach is reported with review of the current literature. A 4-year-old male presented to our institution in January 2012 after having been run over by a tractor. He presented with gross hemodynamical instability, MISS of 25, and an unstable lateral compression type III pelvic fracture with complete anterior dislocation of the left hemipelvis and a groin wound extending into the left thigh. The patient was managed in accordance with the ATLS and open fracture guidelines. Reduction in the dislocated SI joint was achieved via a posterior approach to the SI joint, followed by fixation with 2K wires in S1 and S2 sacral segments, with an anterior external fixator. Pelvic asymmetry post-reduction was 0.9 cm, compared to 16 cm post-injury, and asymmetry persisted till final follow-up at 5 years. At 5 years, patient regained full function, including recreational sport activities. Patients scored a 96/96 on the Majeed score (after excluding 4 points for sexual function). We believe that posterior reduction in an anteriorly dislocated SI joint in the pediatric population is a viable option. A coordinated, multidisciplinary approach and restoration of pelvic ring stability can lead to optimal outcome.

Keywords: Pediatric pelvic fracture; Pediatric trauma; Pelvic fracture

References

  1. Rev Bras Ortop. 2015 Nov 16;45(6):583-9 - PubMed
  2. J Pediatr Orthop. 2012 Mar;32(2):162-8 - PubMed
  3. J Pediatr Orthop. 2005 Jan-Feb;25(1):34-8 - PubMed
  4. J Bone Joint Surg Am. 2005 Nov;87(11):2423-31 - PubMed
  5. J Trauma. 2004 Jan;56(1):83-8 - PubMed
  6. Int J Surg Case Rep. 2017;36:167-169 - PubMed
  7. J Bone Joint Surg Br. 1989 Mar;71(2):304-6 - PubMed
  8. Semin Pediatr Surg. 2017 Feb;26(1):27-35 - PubMed
  9. J Child Orthop. 2017;11(1):49-56 - PubMed
  10. J Pediatr Surg. 1996 Jan;31(1):82-5 - PubMed
  11. J Orthop Trauma. 2016 Jan;30(1):41-7 - PubMed
  12. J Child Orthop. 2017 Jun 1;11(3):195-200 - PubMed
  13. J Trauma. 2003 Jun;54(6):1146-51; discussion 1151 - PubMed
  14. J Pediatr Surg. 1980 Dec;15(6):719-26 - PubMed

Publication Types