Treatment of acetabular fractures in pediatric patients

The present review of current scientific and practical literature is devoted to the analysis of modern diagnostics and management of acetabulum fractures in children. Systematized research and clinical findings have proven that computed tomography remains the “gold standard” for diagnostics (accuracy up to 80%) of acetabulum fractures in children. However, it is not available in some regional hospitals what increases the risk of intraoperative errors committed by an orthopedic traumatologist and a pediatric surgeon. Conservative management (plaster casts, skeletal traction) is acceptable in undisplaced fractures, but it is associated with a high risk of complications: thrombosis, deformities (including the extremity discrepancy in the growing organism), osteoarthritis, etc. Surgical intervention is indicated in dislocated fragments of more than 2 mm, joint instability or damage to the posterior wall of the cavity. The optimal access depends on the fracture location and surgeon’s experience. The key success factors for treating acetabulum fractures in children are: reposition of the dislocation within the first 6 hours, compliance with aseptic rules, and early rehabilitation. The authors emphasize the need to equip regional and district hospitals with computer/magnetic resonance devices, to develop unified protocols and to train surgeons in minimally invasive techniques. The results obtained in the study are important for improving pediatric traumatology.