[Mechanisms and frequency of urologic complications in 73 cases of unstable pelvic fractures].
OBJECTIVE
To analyse the urological complications of unstable pelvic fractures and to try to establish a correlation between the type of urological complication observed and the type of pelvic fracture.


METHODS
The urological complications of 73 unstable pelvic fractures observed between 1977 and 1996 were analysed. Fractures of the obturator foramen were excluded from the study. Pelvic fractures were classified according to the criteria of the Tile classification, comprising 3 main types: type A corresponds to stable fractures not involving the pelvic brim; type B corresponds to fractures with rotary instability and type C corresponds to fractures with vertical instability.


RESULTS
12 men (12.5%) developed urological complications: 7 ruptures of the membranous urethra (3 type C, 4 type B), 4 intraperitoneal ruptures of the bladder (3 type C and 1 type B) and one extraperitoneal rupture of the bladder (type A). The mean age of these patients was 37 years (range: 14 to 56). The mortality was 50%.


CONCLUSIONS
Urological complications are rare after pelvic fractures, but must be systematically investigated. The Tile classification is useful to understand the mechanisms responsible for urological complications of pelvic fractures. Unstable fractures (type B and C) are at greatest risk of urological complications. Type B or C fractures are not correlated with a specific type of urological complication.
Paparel
Philippe
P
Service d'Urologie et de Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon, France. paparelphilippe@aol.com
Badet
Lionel
L
Tayot
Olivier
O
Fessy
Michel-Henri
MH
Bejui
Jacques
J
Martin
Xavier
X
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D050723:Fractures, Bone / Q000145:classification / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries*; D012189:Retrospective Studies; D014570:Urologic Diseases / Q000145:classification / Q000209:etiology*
Mécanismes et fréquence des complications urologiques de 73 fractures instables du bassin.