PELVIC FRACTURE DIAGNOSTICS IN CHILDREN WITH POLYTRAUMA

The paper focuses on child pelvic fractures occurring in up to 5% of the polytrauma injured. The aforementioned traumas differ from adult pelvic fractures and require a specific therapeutic approach. At present, there is no consensus on the priority of one of the following visualization types: computed tomography and magnetic resonance imaging. The order of diagnosing a pelvis injury in child polytrauma cases is also debatable. The article presents the pelvic trauma diagnostic capabilities of computed tomography and magnetic resonance imaging among children with polytrauma. A cohort of 187 pediatric patients with pelvic injuries and polytrauma (mean age, 13.5 years) is investigated. Multislice computed tomography using a 128-slice “Ingenuity Elite 128” (Philips) scanner is performed on all patients. The 3T scanner magnetic resonance imaging is conducted on 21 children, and fat suppressed 3D versions of multiplanar STIR, T1-, T2-, and PD weighted images are obtained. Injury severity score (ISS) of the 187 children varied from 26.47 to 28.1 points with the average range
of 26.11±1.5. The 72.72% (n = 136) of the pelvic fractures are multiple, 21.39% (n = 40) are complex, 23.52% (n = 44) are unstable. Among 69 patients diagnosed with anterior pelvic ring injury according to computed tomography, magnetic resonance imaging has found 68.11% (n = 47) cases of comorbid posterior pelvic ring fractures. Computed tomography conduction on children with suspected pelvic injuries are obligatory for polytrauma instances. While magnetic resonance imaging has a high sensitivity diagnosing all non-muscular and pelvis injury types, computed tomography is preferable in specified cases due to its operation speed and metal stabilizers.

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