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Abstract
Anterior pelvic ring disruptions are often associated with injuries to the genitourinary structures with the potential for considerable resultant morbidity. Herniation of the bladder into the symphyseal region after injury with subsequent entrapment upon reduction of the symphyseal diastasis has seldom been reported in the literature. We report such a case involving bladder herniation and subsequent entrapment after attempted closed reduction with anterior pelvic external fixation immediately treated with open reduction and internal fixation along with a review of the literature.
Highlights
Pelvic fractures are a small but clinically significant percentage of all fractures
Associated injuries to the genitourinary structures ranging from urethral and prostatic injuries to complete bladder rupture with resultant morbidity have been described in the literature [1,2,3,4,5]
We report a case involving bladder herniation through a traumatic symphyseal diastasis with subsequent incarceration after attempted reduction with pelvic external fixation and a review of the literature
Summary
Pelvic fractures are a small but clinically significant percentage of all fractures. Associated injuries to the genitourinary structures ranging from urethral and prostatic injuries to complete bladder rupture with resultant morbidity have been described in the literature [1,2,3,4,5]. We report a case involving bladder herniation through a traumatic symphyseal diastasis with subsequent incarceration after attempted reduction with pelvic external fixation and a review of the literature. The patient was returned to the operating room later the same day by the orthopaedic traumatologist for removal of the external fixator, open reduction and internal fixation of the pubic symphysis dislocation, and percutaneous screw fixation of the right sacroiliac joint. Follow-up radiographs revealed further residual displacement of the symphysis and SI joint without obvious failure to the plate or screw fixation (Figure 6: 12 month follow-up AP pelvis radiograph showing mild loss of symphyseal reduction.). 1oF2figsmuymroenpth6hysfoealllorwe-duupctAioPnpelvis radiograph showing mild loss 12 month follow-up AP pelvis radiograph showing mild loss of symphyseal reduction
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