Impact of urethral injury management on the treatment and outcome of concurrent pelvic fractures
| Autor: | James L. Guyton, Brant E Mayher, Jeffrey R. Gingrich |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Male
Sacrum medicine.medical_specialty Adolescent Urology Ilium Fractures Bone Urethra medicine Humans Pelvic Bones Pubic Bone Retrospective Studies Surgical repair medicine.diagnostic_test business.industry Pelvic pain Accidents Traffic Acetabulum Retrospective cohort study Middle Aged medicine.disease Surgery Endoscopy Catheter medicine.anatomical_structure Orthopedic surgery Pelvic fracture medicine.symptom Urinary Catheterization business Femoral Fractures |
| Zdroj: | Urology. 57:439-442 |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/s0090-4295(00)01038-4 |
| Popis: | Objectives. Multiple treatment options exist for concurrent posterior urethral trauma and pelvic fractures. Because of the increased risk of contamination, the surgical repair of fractures may be prohibited by suprapubic urologic catheters. To characterize the incidence and long-term outcomes of these management conflicts, we reviewed our experience with concomitant pelvic fractures and posterior urethral injuries. Methods. For a 42-month period, 61 patients with concurrent lower urinary tract and pelvic trauma, including 23 with posterior urethral injuries, were retrospectively reviewed for conflicts between urologic management and optimal treatment of the associated orthopedic injuries. Results. Of the 23 posterior urethral injuries identified, the management of 8 (35%) was noted to impact the decision regarding the management and outcome of the concurrent pelvic fractures. Although the overall difference in the length of hospitalization and period of immobilization was not statistically significant, of the 4 patients whose suprapubic catheter precluded surgical orthopedic fracture repair, 3 patients (75%) remain disabled because of chronic pelvic pain, and none of those who underwent early endoscopic realignment remain disabled because of their pelvic fracture. Conclusions. Endoscopic realignment for traumatic posterior urethral injuries associated with pelvic fractures, particularly acetabular fractures, should be attempted to avoid the increased morbidity associated with conservative management of the concurrent orthopedic injuries. |
| Databáze: | OpenAIRE |
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