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  • Title: [Mechanisms and frequency of urologic complications in 73 cases of unstable pelvic fractures].
    Author: Paparel P, Badet L, Tayot O, Fessy MH, Bejui J, Martin X.
    Journal: Prog Urol; 2003 Feb; 13(1):54-9. PubMed ID: 12703355.
    Abstract:
    OBJECTIVES: 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. MATERIAL AND 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%. CONCLUSION: 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.
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