Sacroiliac Joint Remodeling in a Post-Traumatic Child: A Case Report

Abstract Background: Sacroiliac joint (SIJ) remodeling in pediatric patients following trauma is a rare phenomenon, with limited documentation in medical literature. This case report presents a unique instance of post-traumatic SIJ remodeling in a child, highlighting the novel imaging findings and the successful outcome achieved through multidisciplinary care. The case contributes valuable insights into the management of pediatric SIJ injuries and the distinctive anatomical responses involved in the healing process. Case Presentation: An 11-year-old girl was admitted ten days after a motorbike accident, presenting with severe right hemipelvis pain and an inability to move her leg. Imaging revealed a dislocation of the right SIJ, a superior and posterior displacement of the hemipelvis, and a separation of the pubic symphysis. Initial attempts at closed reduction were unsuccessful, leading to surgical intervention with the placement of a percutaneous SIJ screw and an external fixation stent. Despite incomplete initial reduction, the patient underwent multidisciplinary rehabilitation. At three months post-operation, she was walking without pain, and CT scans showed remodeling of the SIJ, with the right joint adapting to match the sacral articular surface. The SIJ screw was removed at six months, and the patient fully returned to her pre-injury state, with equal limb lengths and no functional deficits. Conclusions: This case underscores the importance of recognizing the unique anatomical and physiological responses of pediatric SIJ to trauma. Timely diagnosis, multidisciplinary management, and careful consideration of growth and development are key to achieving favorable outcomes in children with post-traumatic SIJ injuries. This report highlights the potential for significant joint remodeling and the importance of tailored rehabilitation in pediatric patients.