Neglected Traumatic Sacroiliac Joint Disruption in a Young Child: Delayed Open Reduction and Functional Recovery.
- 1Department of Orthopedic, Yashoda Hospital, Hyderabad, Telangana, India.
- 2Department of Orthopedic, Osmania General Hospital, Hyderabad, Telangana, India.
- 3Department of Orthopedic, Gandhi Hospital, Secunderabad, Hyderabad, Telangana, India.
Abstract
Traumatic sacroiliac (SI) joint disruption is rare in young children and may lead to significant functional disability when diagnosis and treatment are delayed. Management is challenging due to the immature pelvis and the need to preserve growth potential. An 18-month-old girl, who had been walking independently before the injury, presented 3 months after sustaining trauma following a fall from a tractor. She had initially been managed conservatively at another hospital but continued to experience right lower-back pain and an inability to walk. Clinical examination revealed the right lower limb held in flexion, abduction, and external rotation, with restricted right hip movements and tenderness over the right SI joint. Radiographs and computed tomography demonstrated disruption of the right SI joint with anterior displacement of the right hemipelvis and associated pubic symphysis disruption. In view of the persistent displacement and significant functional impairment, delayed open reduction of the SI joint was performed using a Cobb elevator and a Schanz pin placed in the iliac crest to facilitate reduction. The reduction was stabilized using 3-mm Kirschner wires. Postoperatively, the child was maintained on non-weight-bearing status with bed exercises for 6 weeks, following which mobilization was initiated. The Kirschner wires were removed 3 months after surgery. Independent walking was regained 6 months postoperatively. At the latest follow-up, the child was able to walk independently and sit cross-legged comfortably. Follow-up radiographs demonstrated maintained SI-joint reduction without secondary displacement or loss of reduction. Carefully performed delayed open reduction can restore pelvic alignment and achieve satisfactory functional recovery in neglected pediatric SI-joint injuries. Long-term clinical and radiological surveillance is essential to monitor pelvic growth and identify potential complications.
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BibTeX
@article{mahadevuni2026neglected,
title = {{Neglected Traumatic Sacroiliac Joint Disruption in a Young Child: Delayed Open Reduction and Functional Recovery.}},
author = {Vishwanath Mahadevuni and P L Srinivas and L Ramesh and Pradeep Kumar A Sale},
journal = {Journal of orthopaedic case reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8482},
url = {https://europepmc.org/article/MED/42997065},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Neglected Traumatic Sacroiliac Joint Disruption in a Young Child: Delayed Open Reduction and Functional Recovery.
AU - Vishwanath Mahadevuni
AU - P L Srinivas
AU - L Ramesh
AU - Pradeep Kumar A Sale
PY - 2026
DA - 2026/11/01
JO - Journal of orthopaedic case reports
DO - 10.13107/jocr.2026.v16.i11.8482
UR - https://europepmc.org/article/MED/42997065
AB - Traumatic sacroiliac (SI) joint disruption is rare in young children and may lead to significant functional disability when diagnosis and treatment are delayed. Management is challenging due to the immature pelvis and the need to preserve growth potential. An 18-month-old girl, who had been walking independently before the injury, presented 3 months after sustaining trauma following a fall from a tractor. She had initially been managed conservatively at another hospital but continued to experience right lower-back pain and an inability to walk. Clinical examination revealed the right lower limb held in flexion, abduction, and external rotation, with restricted right hip movements and tenderness over the right SI joint. Radiographs and computed tomography demonstrated disruption of the right SI joint with anterior displacement of the right hemipelvis and associated pubic symphysis disruption. In view of the persistent displacement and significant functional impairment, delayed open reduction of the SI joint was performed using a Cobb elevator and a Schanz pin placed in the iliac crest to facilitate reduction. The reduction was stabilized using 3-mm Kirschner wires. Postoperatively, the child was maintained on non-weight-bearing status with bed exercises for 6 weeks, following which mobilization was initiated. The Kirschner wires were removed 3 months after surgery. Independent walking was regained 6 months postoperatively. At the latest follow-up, the child was able to walk independently and sit cross-legged comfortably. Follow-up radiographs demonstrated maintained SI-joint reduction without secondary displacement or loss of reduction. Carefully performed delayed open reduction can restore pelvic alignment and achieve satisfactory functional recovery in neglected pediatric SI-joint injuries. Long-term clinical and radiological surveillance is essential to monitor pelvic growth and identify potential complications.
SN - 2250-0685
SN - 2321-3817
ER -