Clinical treatment of open pelvic fractures associated with anorectal injury

Abstract

Objective To investigate the clinical treatment of open pelvic fractures associated with anorectal injury. Methods We retrospectively reviewed the medical data of 19 patients who had been treated at our department between October 1998 and October 2008 for open pelvic fractures associated with anorectal injury. By Tile classification, there were 1 type A, 5 type B and 13 type C. Three cases suffered from intraperitoneal rectal injury, 11 from extraperitoneal rectal injury and 5 from injury to the anal canal. Their treatment was carried out in 4 steps. First, emergency resuscitation to rescue life and control massive hemorrhage; second, sigmoid colon ostomy and debridement to handle anorectal injury; third, management of the pelvic fracture; fourth, later wounds management. Resnits No death occurred in this group. All the 19 patients were followed up for 12 to 48 (average, 18) months. The anorectal injury was cured in 18 cases and improved in 1 case. According to the Majeed evaluation, the outcome of pelvic fractures was excellent in 3 cases, good in 11, fair in 4, and poor in 1. The good to excellent rate was 73. 7%. The wounds healed at one or two stages after grafting and flap transfer in 18 eases. Conclusion C, oed outcome of open pelvic fractures associated with anorectal injury may result from timely emergency resuscitation, aggressive manage-ment of anorectal injury and proper management of pelvic fractures by orthopaedists in cooperation with spe-cialists from other disciplines. Key words: Pelvis; Fractures, open; Rectum; Anal canal