Diagnosis and treatment of rare complications of pelvic fractures

Zong, Zhaowen; Bao, Quanwei; Liu, Huayu; Shen, Ya; Zhao, Yuhai; Xiang, Hua; Qing-shan, Guo; Zhang, Lianyang; Chen, Hui

doi:10.1016/j.cjtee.2015.12.012

Cited by 10 publications

(6 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Testicular dislocation is even more rarely encountered than injuries like PFUI. However, there are significant consequences if testicular dislocation is missed; therefore, it should always be closely assessed pre- and intra-operatively in pelvic ring injuries [ 1 , 2 , 4 , 8 ]. In the author’s opinion, this is the most important takeaway from this case.…”

Section: Discussionmentioning

confidence: 99%

“…Injuries to the pelvic ring account for approximately 12% of admissions to trauma centers each year [ 1 ]. Significant reproductive and genitourinary complications have been associated with traumatic pelvic ring disruptions.…”

Section: Introductionmentioning

confidence: 99%

“…With recent investigations citing as few as 60 total cases [ 8 ], there exists a paucity in the current literature regarding accurate and expedient diagnosis as well as management of these injuries. If left unattended or mishandled, these injuries may lead to impaired fertility, hypogonadism, or testicular necrosis [ 1 , 2 , 4 , 8 ]. We present a case of unilateral testicular dislocation with pelvic ring instability that was not diagnosed until the time of surgery.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Testicular Dislocation After Unstable Pelvic Ring Injury

Bernhard

Myers

Passias

et al. 2021

Cureus

View full text Add to dashboard Cite

Reproductive and genitourinary complications following pelvic ring injuries have been described; however, testicular dislocation is rare and can cause significant morbidity if not managed appropriately. We describe a case of testicular dislocation after pelvic ring injury and outline the subsequent management and outcome, and seek to identify areas of improvement to ensure expedient and appropriate care in the setting of these injuries. Our case describes a 29-year-old male who presented to a level-one trauma center following a motorcycle collision. An anteroposterior compression type II rotationally unstable pelvic ring was identified on imaging. He was hemodynamically unstable and computed tomography (CT) with angiography was ordered. Arterial extravasation was noted from the bilateral anterior internal iliac arteries, which were subsequently embolized by interventional radiology. However, no concomitant genitourinary injury was identified at the time of CT. After resuscitation, the pelvis was stabilized with an anterior symphyseal plate and bilateral sacroiliac screws. During the anterior pelvic approach, the patient’s dislocated testicle was surprisingly discovered inferior to the pubis. Urology was consulted intra-operatively, and the testicle was successfully relocated. At the final follow-up, the pelvic ring was healed without any noticeable urogenital complication. While testicular dislocation has been reported in the setting of pelvic ring injury, a paucity of information exists regarding management, implications, and areas for improvement in the identification of these injuries. Therefore, in cases of pelvic ring injury with significant trauma, radiologists, traumatologists, and orthopedic surgeons should adopt a multi-disciplinary approach in diligently attempting to rule out testicular dislocation pre-operatively. Intra-operatively, examination under anesthesia and careful operative technique are important in preventing iatrogenic injury.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Testicular Dislocation After Unstable Pelvic Ring Injury

Bernhard

Myers

Passias

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…The protocol followed the recommendations of the Advanced Trauma Life Support guideline. [ 21 , 22 ] First, patients with unstable pelvic injuries were immediately equipped with a pelvic binder. Endotracheal intubation and mechanical ventilation were performed when necessary, based on the level of consciousness and breathing patterns of the patient.…”

Section: Methodsmentioning

confidence: 99%

Prolonged ileus in traumatic pelvic ring injury patients who underwent arterial angio-embolization: A retrospective study

et al. 2022

View full text Add to dashboard Cite

Paralytic ileus occurs in up to 18% of the patients with pelvic bone fractures. The aim of this study is to determine if massive bleeding requiring arterial angio-embolization is related with the duration of ileus in patients with traumatic pelvic ring injuries. This retrospective study included 25 patients who underwent arterial angio-embolization for traumatic pelvic ring injuries. Data were collected from prospectively maintained databases of two independent hospitals. Demographic characteristics (such as age, sex, body mass index, and Charlson Comorbidity Index), cause of trauma, and severity of pelvic injuries were similar in the non-prolonged and prolonged ileus groups. As expected, the prolonged ileus group had a significantly longer duration of ileus than the non-prolonged ileus group (8.0 ± 4.2 days vs 1.2 ± 0.4 days, respectively; P < .001). The mortality rate was higher in the prolonged ileus group (20% vs 0%), but it was not significantly different ( P = .13). Interestingly, the prolonged ileus group received significantly higher amounts of packed red blood cell transfusions (6.1 ± 2.1 units vs 3.8 ± 2.5 units; P = .02). The amount of packed red blood cell transfusions was associated with a greater risk of prolonged ileus development ( P = .03, odds ratio = 2.04, 95% confidence interval = 1.08–3.88). This study supports the idea that the duration of the ileus is related with the amount of bleeding caused by the traumatic pelvic ring injury. In order to prevent further complications, conservative treatments of the ileus should be considered.

show abstract

“…Testicular trauma can be associated with pelvic fractures, especially in the case of motor vehicle crashes and falls from a height [ 66 ].…”

Section: Vascular and Visceral Complicationsmentioning

confidence: 99%

Imaging Review of Pelvic Ring Fractures and Its Complications in High-Energy Trauma

et al. 2022

View full text Add to dashboard Cite

Pelvic ring fractures are common in high-energy blunt trauma, especially in traffic accidents. These types of injuries have a high rate of morbidity and mortality, due to the common instability of the fractures, and the associated intrapelvic vascular and visceral complications. Computed tomography (CT) is the gold standard technique in the evaluation of pelvic trauma because it can quickly and accurately identify pelvic ring fractures, intrapelvic active bleeding, and lesions of other body systems. To properly guide the multidisciplinary management of the polytrauma patient, a classification criterion is mandatory. In this review, we decided to focus on the Young and Burgess classification, because it combines the mechanism and the stability of the fractures, helping to accurately identify injuries and related complications.

show abstract

Diagnosis and treatment of rare complications of pelvic fractures

Cited by 10 publications

References 37 publications

Testicular Dislocation After Unstable Pelvic Ring Injury

Testicular Dislocation After Unstable Pelvic Ring Injury

Prolonged ileus in traumatic pelvic ring injury patients who underwent arterial angio-embolization: A retrospective study

Imaging Review of Pelvic Ring Fractures and Its Complications in High-Energy Trauma

Contact Info

Product

Resources

About