Simultaneous Treatment of Pelvic and Urological Injuries
Pelvic fractures have a bimodal incidence, occurring via low-energy mechanisms in the elderly and high-energy mechanisms in young patients; the present review will focus primarily on the latter. Patients typically present in the acute trauma setting. A review of one trauma database demonstrated that 1,545 (9.3%) of 16,630 patients had pelvic fractures1. Of the patients with pelvic fracture, 16.5% had a concomitant abdominal injury and 5.8% had injuries affecting the bladder or urethra, making these structures the second-most-common sites of concomitant injury after the liver1. Pelvic injury includes pubic symphysis diastasis, fracture of the pubic rami, fractures of the iliac wings, sacroiliac joint injury, acetabular fracture, sacral fracture, or any combination of these injuries2. Common injury patterns were further classified by Young and Burgess, who described 4 common injury patterns according to proposed mechanisms of injury: anterior posterior compression (APC), lateral compression (LC), vertical shear, and complex3. It is important for orthopaedic surgeons to be aware of the urological complications that can occur as well as their basic treatment and outcomes. In addition, consulting urologists need to consider the concomitant orthopaedic treatment.