Module 18, Pediatric Orthopaedist Level

1,2,3,4,5

A 16 year old female was previously in good health when she was involved in a roll-over motor vehicle accident as an unrestrained passenger, and ejected from the vehicle. She landed in a field. She was taken by ambulance to a nearby hospital complaining of pain in the pelvis. An x-ray of her pelvis was obtained (image 1), Obturator and iliac oblique(image 2), A CT scan of the fracture was obtained (images 3, 4 & 5).

Question 18A

This definitely indicates a displaced fracture and requires an open reduction.

Question 18B

Bedrest for several weeks until the hip is very comfortable followed by partial weight bearing is clearly the treatment choice.

Question 18C

In young children with pelvic fractures an arthrogram is often helpful.

Question 18D

An absolute indication for open reduction in this case would be if the hip joint is not completely reduced.

Question 18E

If an open reduction is planned the best approach would be the ilioinguinal approach.

Go to Next Question Module, Go to General Orthopaedist Level Modules, Go to Question Module Home Page, Go to Case Presentation Home Page, Orthopaedic Department Home Page.