Early operative treatment of pelvic fractures associated with urethral disruption / 中华外科杂志
Zhonghua Wai Ke Za Zhi
; (12): 249-253, 2007.
Article
in Zh
| WPRIM
| ID: wpr-334364
Responsible library:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the early operative treatment and clinical results of pelvic fractures associated with urethra disruption.</p><p><b>METHODS</b>From January 1995 to January 2005, 25 patients suffered from pelvic fractures combined urethra disruption treated by operation were retrospectively analyzed. According to Tile's classification, 1 case was stable pelvic fracture, 17 rotational unstable fractures, and 7 rotational combined vertical unstable fractures. The complete urethra rupture were in 23 cases and incomplete in 2 cases. The operative methods included: (1) emergency open reduction and internal fixation of the pelvis combined primary urethra suturing in 2 cases, partial suturing after realignment in 4 cases, realignment in 2 cases, and urethrovaginal penetrating wound repairing in 1 case; (2) primary urethra realignment only and delayed (range, 7 to 21 days) pelvic internal fixation in 10 cases; (3) early cystostomy and delayed (range, 3 to 21 days) urethra realignment and pelvic internal fixation in 6 cases.</p><p><b>RESULTS</b>The mean follow-up time of all patients was 34 months (range from 6 to 120 months). According to Majeed's evaluation, 17 cases of pelvic injury showed excellent results, 5 good, and 3 fare. After urinary catheter removed, the mean maximal urine flow rate of 19 (76%) patients was 18.6 ml/s and the mean scar length between both disrupted ends on the film of excretion urethrography was 0.51 cm. Five (20%) cases suffered in dysuria needed urethral dilatation or further surgery. One (4%) female could not control urination who need a second-look operation. The primary suprapubic soft tissue avulsion wound infection secondary to retropubic abscess was found in 1 case, posterior urethra-stenosis in 5 cases, sexual impotence in 3 cases, and incontinence in 1 case.</p><p><b>CONCLUSIONS</b>The satisfactory reduction and effective fixation of the pelvic fractures is an anatomical basis for receiving "tension-free urethral anastomosis".</p>
Full text:
1
Index:
WPRIM
Main subject:
Pelvic Bones
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Postoperative Complications
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General Surgery
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Time Factors
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Urethra
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Wounds and Injuries
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Retrospective Studies
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Follow-Up Studies
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Treatment Outcome
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Fractures, Bone
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Adult
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Female
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Humans
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Male
Language:
Zh
Journal:
Zhonghua Wai Ke Za Zhi
Year:
2007
Type:
Article