Characteristics of genitourinary injuries associated with pelvic fractures during operation Iraqi Freedom and operation Enduring Freedom.
OBJECTIVE
Pelvic fractures are markers of severe injury and are often associated with lower genitourinary injuries. The purpose of this study was to investigate the incidence of lower genitourinary injuries and complaints associated with pelvic fractures sustained in combat among nonsurvivors and survivors.


METHODS
The Armed Forces Medical Examiner System and The Joint Theater Trauma Registry databases were searched to identify survivors and nonsurvivors who sustained a pelvic fracture in combat in 2008. Survivor and autopsy data consisted of injury mode and mechanism and associated organ and extremity injuries. Pelvic fractures were classified using the Tile system.


RESULTS
The database search yielded 91 nonsurvivors and 10 survivors with pelvic fractures. Forty-one patients (40%) sustained 61 genitourinary injuries. The majority of genitourinary injuries in nonsurvivors were associated with Tile C pelvic fractures (70%). Twenty percent of survivors had genitourinary injuries, all of which were associated with Tile A fractures.


CONCLUSIONS
A higher incidence of genitourinary injuries in patients with combat-related pelvic fractures (60%) was found than that of their civilian counterparts. Of the survivors, 100% of those with genitourinary injuries were being treated for erectile dysfunction at their last follow-up. Continued collaboration between orthopaedic surgeons and urologist is needed to address these concurrent injuries.
Orthopaedic Surgery Department, San Antonio Military Medical Center, 3851 Roger Brooke Drive, San Antonio, TX 78236.
Aasta
A
Pedersen
Orthopaedic Surgery Department, San Antonio Military Medical Center, 3851 Roger Brooke Drive, San Antonio, TX 78236.
Daniel J
DJ
Stinner
Urology Department, Darnall Army Medical Center, 36000 Darnal Loop, Fort Hood, TX 76544.
H Cathy
HC
McLaughlin
Orthopaedic Surgery Department, Naval Hospital Bremerton, 1 Boone Road Suite 2524, Bremerton, WA 98312.
James R
JR
Bailey
Urology Department, Madigan Army Medical Center, 9040 Jackson Avenue, Tacoma, WA 98431.
Jack R
JR
Walter
Department of Orthopaedic Trauma Surgery, Carolinas Medical Center, 1000 Blythe Boulevard, Charlotte, NC 28203.
Joseph R
JR
Hsu
D000328:Adult; D055826:Afghan Campaign 2001-; D005260:Female; D052776:Female Urogenital Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D050723:Fractures, Bone / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D054542:Iraq War, 2003-2011; D008297:Male; D052801:Male Urogenital Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D008889:Military Personnel; D010384:Pelvic Bones / Q000293:injuries*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014566:Urogenital System / Q000293:injuries*; D055815:Young Adult