Background:

High-energy severe pelvic injuries in pediatric patients are rare, particularly those associated with acetabular fractures. They are life threatening injuries.

Method:

We report the case of a pediatric patient with a diagnosis of a Torode/Zieg IVd pelvic fracture. The clinical and radiographic data was reviewed retrospectively.

Clinical case:

Male, 12 year-old polytraumatized patient with an unstable pelvic fracture who underwent multidisciplinary treatment. He was stabilized in the intensive care unit; the general surgery service performed laparotomy; orthopedic management consisted of closed reduction and internal fixation of the sacroiliac fracture-dislocation and later of open reduction and internal fixation of the right acetabular fracture. The patient´s clinical course was appropriate.

Conclusions:

A diagnosis of a type IVd Torode/Zieg fracture is an absolute indication for surgical management. A multidisciplinary approach is essential to save the life of patients with unstable pelvic lesions. This case shows the complexity of an unstable pelvic fracture associated with multiple injuries, due to a rather infrequent mechanism of injury (being crushed by a tree) in a patient with an immature skeletal system.