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Background: Pelvic fractures occur uncommonly in children. Despite serious sequelae, they have been infrequently reviewed., Methods: We conducted a retrospective review of admissions to our institution from January 1983 to December 2000., Results: One hundred twenty children with pelvic fractures were identified. Median age was 9 years (range, 1-16 years) and 66% (n = 80) were boys. Pedestrian-motor vehicle injury accounted for 68% (n = 82) of cases. Associated injuries were present in 78% (n = 94). Management of the pelvic fracture was nonoperative in 113 (94%). Thirty-two children (27%) required surgery for associated injuries. Complications during admission occurred in 28% (n = 34). Five children died as a result of their injuries. With a mean follow-up of 36 months (range, 7-156 months), 27% (n = 32) of children suffered an adverse outcome, including neurologic dysfunction and leg-length discrepancies., Conclusion: The majority of pelvic fractures in children may be satisfactorily treated nonoperatively. Operative interventions were more frequently required for associated injuries. Long-term review is indicated because of delayed complications in children that are continuing to grow and develop.

Objectives: To study mortality and functional outcome in elderly patients suffering major trauma and to assess whether age affects prognosis., Design and Setting: Retrospective identification of patients from the Royal North Shore Hospital, a level three trauma service and teaching hospital of the University of Sydney. The patients were followed up for an average of three years after admission., Patients: One hundred and eighteen patients aged over 60 years, with injury severity scores over 15, admitted consecutively between May 1988 and July 1990. To determine the effects of age on outcome, patients were divided into two groups: those aged 61-70 years (67 patients) and over 70 years (51 patients)., Main Outcome Measures: Death in hospital, late death after discharge, change in preinjury v. current accommodation and current functional ability, measured with the Barthel activities of daily living index., Results: Thirty-six of the 118 patients died in hospital. Eighty-one of the remaining 82 patients were followed up. Twenty-five of these patients died during the study period: three in the 61-70 years age group, and 22 in the over 70 years age group (P < 0.0001). Among the long term survivors, 43 of 53 continued to live independently, and 41 of 54 scored maximum points in activities of daily living assessment. Only seven people required nursing home care., Conclusions: Age is an important factor in survival after major trauma, but those that do survive generally return to full activity and independence. Aggressive treatment for elderly trauma victims is warranted.