Open pelvic fracture with vaginal laceration and diaphragmatic rupture in a child.

A case report of a 4-year-old child who sustained an unstable open pelvic fracture with a diaphragmatic rupture is presented. A strong correlation exists between rupture of the diaphragm and pelvic fractures. We note the difference between pediatric and adult pelvic fractures, and discuss late complications unique to the child with a pelvic fracture. Pelvic external fixation is faster and less morbid than other surgical treatments for unstable pelvic fractures, and therefore provides an excellent alternative to pelvic open reduction in the acute treatment of pediatric patients with multi-system injuries. If fracture reduction is incomplete following initial closed manipulation, a staged secondary open reduction can then be performed.