Analysis of risk factors affecting the prognosis of external fixation in the treatment of unstable pelvic fractures in children: a retrospective study of 96 patients
Abstract Background To investigate the efficacy of external fixation in treating unstable pelvic fractures in children and identify risk factors for poor prognosis. Methods A retrospective study was conducted on children with unstable pelvic fractures treated surgically at our hospital from January...
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BMC
2025-05-01
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| Series: | BMC Pediatrics |
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| Online Access: | https://doi.org/10.1186/s12887-025-05485-z |
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| author | Hanwen Zhang Ronghao Zhao Danjiang Zhu Wei Feng Baojian Song Qiang Wang |
| author_facet | Hanwen Zhang Ronghao Zhao Danjiang Zhu Wei Feng Baojian Song Qiang Wang |
| author_sort | Hanwen Zhang |
| collection | DOAJ |
| description | Abstract Background To investigate the efficacy of external fixation in treating unstable pelvic fractures in children and identify risk factors for poor prognosis. Methods A retrospective study was conducted on children with unstable pelvic fractures treated surgically at our hospital from January 2006 to June 2022. All patients received external fixation, and those with vertical instability underwent postoperative limb traction. Data collected included gender, age, injury mechanism, associated injuries, imaging results, operation time, blood loss, pelvic reduction status, complications, and functional recovery. Variables were analyzed using multiple linear regression to explore risk factors for poor prognosis. Results The study included 96 patients (62 males, 34 females) with an average age of 95.7 ± 50.3 months. Injury mechanisms were mainly traffic accidents (82.3%) and falls (14.6%). There were 47 cases of Tile B fractures and 49 cases of Tile C fractures. Surgeries were successful with an average operation time of 55.6 ± 27.3 min and blood loss of 6.3 ± 4.7 ml. Immediate postoperative Matta reduction quality was excellent in 91.7% of cases. Postoperatively, 46 patients underwent limb traction for an average of 9.3 ± 1.4 weeks. The average follow-up duration was 29.3 ± 11.7 months, and fracture healing time was 8.6 ± 1.1 weeks. At the final follow-up, 83.3% had excellent or good Cole pelvic function scores. WeeFIM scores indicated complete independence in 71 cases, conditional independence in 13, and conditional dependence in 12. Multiple linear regression identified age, Tile classification, and immediate postoperative displacement as independent predictors of prognosis. Patients aged ≥ 13 years, with Tile C fractures, and immediate postoperative displacement ≥ 8 mm had lower Cole scores. Conclusions External fixation combined with lower limb traction effectively treats unstable pelvic fractures in children, with most patients having a favorable prognosis. Assessment of age, fracture type, and reduction quality is essential. Enhanced postoperative follow-up and functional exercises are recommended for older children, those with Tile C fractures, and those with significant immediate postoperative displacement. Clinicians should consider these factors to improve outcomes. Level of evidence III |
| format | Article |
| id | doaj-art-5a1e0252de9b4f8296e5a9f0553cca9a |
| institution | Kabale University |
| issn | 1471-2431 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | BMC Pediatrics |
| spelling | doaj-art-5a1e0252de9b4f8296e5a9f0553cca9a2025-08-20T03:53:13ZengBMCBMC Pediatrics1471-24312025-05-012511810.1186/s12887-025-05485-zAnalysis of risk factors affecting the prognosis of external fixation in the treatment of unstable pelvic fractures in children: a retrospective study of 96 patientsHanwen Zhang0Ronghao Zhao1Danjiang Zhu2Wei Feng3Baojian Song4Qiang Wang5Department of Orthopedics, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Orthopedics, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Orthopedics, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Orthopedics, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Orthopedics, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Orthopedics, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthAbstract Background To investigate the efficacy of external fixation in treating unstable pelvic fractures in children and identify risk factors for poor prognosis. Methods A retrospective study was conducted on children with unstable pelvic fractures treated surgically at our hospital from January 2006 to June 2022. All patients received external fixation, and those with vertical instability underwent postoperative limb traction. Data collected included gender, age, injury mechanism, associated injuries, imaging results, operation time, blood loss, pelvic reduction status, complications, and functional recovery. Variables were analyzed using multiple linear regression to explore risk factors for poor prognosis. Results The study included 96 patients (62 males, 34 females) with an average age of 95.7 ± 50.3 months. Injury mechanisms were mainly traffic accidents (82.3%) and falls (14.6%). There were 47 cases of Tile B fractures and 49 cases of Tile C fractures. Surgeries were successful with an average operation time of 55.6 ± 27.3 min and blood loss of 6.3 ± 4.7 ml. Immediate postoperative Matta reduction quality was excellent in 91.7% of cases. Postoperatively, 46 patients underwent limb traction for an average of 9.3 ± 1.4 weeks. The average follow-up duration was 29.3 ± 11.7 months, and fracture healing time was 8.6 ± 1.1 weeks. At the final follow-up, 83.3% had excellent or good Cole pelvic function scores. WeeFIM scores indicated complete independence in 71 cases, conditional independence in 13, and conditional dependence in 12. Multiple linear regression identified age, Tile classification, and immediate postoperative displacement as independent predictors of prognosis. Patients aged ≥ 13 years, with Tile C fractures, and immediate postoperative displacement ≥ 8 mm had lower Cole scores. Conclusions External fixation combined with lower limb traction effectively treats unstable pelvic fractures in children, with most patients having a favorable prognosis. Assessment of age, fracture type, and reduction quality is essential. Enhanced postoperative follow-up and functional exercises are recommended for older children, those with Tile C fractures, and those with significant immediate postoperative displacement. Clinicians should consider these factors to improve outcomes. Level of evidence IIIhttps://doi.org/10.1186/s12887-025-05485-zUnstable pelvic fractureChildrenExternal fixationPrognostic risk factorsAge |
| spellingShingle | Hanwen Zhang Ronghao Zhao Danjiang Zhu Wei Feng Baojian Song Qiang Wang Analysis of risk factors affecting the prognosis of external fixation in the treatment of unstable pelvic fractures in children: a retrospective study of 96 patients BMC Pediatrics Unstable pelvic fracture Children External fixation Prognostic risk factors Age |
| title | Analysis of risk factors affecting the prognosis of external fixation in the treatment of unstable pelvic fractures in children: a retrospective study of 96 patients |
| title_full | Analysis of risk factors affecting the prognosis of external fixation in the treatment of unstable pelvic fractures in children: a retrospective study of 96 patients |
| title_fullStr | Analysis of risk factors affecting the prognosis of external fixation in the treatment of unstable pelvic fractures in children: a retrospective study of 96 patients |
| title_full_unstemmed | Analysis of risk factors affecting the prognosis of external fixation in the treatment of unstable pelvic fractures in children: a retrospective study of 96 patients |
| title_short | Analysis of risk factors affecting the prognosis of external fixation in the treatment of unstable pelvic fractures in children: a retrospective study of 96 patients |
| title_sort | analysis of risk factors affecting the prognosis of external fixation in the treatment of unstable pelvic fractures in children a retrospective study of 96 patients |
| topic | Unstable pelvic fracture Children External fixation Prognostic risk factors Age |
| url | https://doi.org/10.1186/s12887-025-05485-z |
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