Associated Urogenital Injuries Following Pelvic Trauma in Pediatrics: A 15-Year Single-Center Retrospective Study

Objectives: The association between pelvic trauma and urogenital injuries in adults is well-established, whereas pediatric literature is forthcoming. This study aimed to determine the association between pelvic trauma and urogenital injuries in pediatric patients, including incidence, injury patterns, diagnosis, and treatment. We hypothesized that pediatric patients would demonstrate decreased rates of urogenital injuries associated with pelvic trauma compared to adults. Methods: This was a single-center, retrospective chart review. Patients aged 0-16 years admitted for pelvic fracture, pelvic dislocation, proximal femur fracture, and injury of urinary and pelvic organs over a 15-year period were included. Primary variables included fracture diagnosis, urogenital injury, treatment modalities, and mechanism of injury. Secondary outcomes included patient demographics, length of hospital and intensive care unit (ICU) stay, imaging, and Foley placement. ANOVA and chi-square analysis were used for statistical analysis. Results: A total of 371 patient charts were reviewed. Following additional exclusion criteria, 303 patients were compared for analysis. Patients were grouped based on primary fracture diagnosis: pelvic ring fracture (49.2%, n = 149), femur fracture (42.2%, n = 128), and acetabular fracture/hip dislocation (8.6%, n = 26). There was no associated urogenital injury in 81.9% (n = 122) of the pelvic ring fracture group, 90.6% (n = 116) of the femur fracture group, and 100% (n = 26) of the acetabular fracture/hip dislocation group (p = 0.0690). Conclusions: Pelvic trauma with associated urogenital injury is less likely in pediatric patients than in adults. When present, it is more commonly associated with the male gender and increased pelvic fracture severity. Level of evidence: Level III - retrospective chart review.