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Chronic pelvic insufficiency fractures and their treatment.
Arch Orthop Trauma Surg
December 2024
Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Article Synopsis
- Fragility and insufficiency fractures of the pelvis and sacrum are on the rise among the elderly due to weakened bones, leading to persistent pain, reduced mobility, and a risk of loss of independence.
- While conservative treatments are an option, surgery is often preferred for unstable fractures, especially since many patients do not receive adequate preventative care for osteoporosis-related fractures.
- Diagnostic imaging is crucial for identifying these fractures, with CT scans being the gold standard, but MRI offers the highest sensitivity for detecting complex fractures, guiding treatment based on fracture type and stability.
"Primary" bulbar urethral ischemic necrosis following pelvic fracture urethral injury: A rare surgical challenge.
Indian J Urol
December 2023
Department of Urology and Renal Transplant, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Ischemic necrosis of the bulbar urethra in a patient with pelvic fracture urethral injury without a prior history of surgical intervention is extremely rare and results in long-segment obliterative strictures that are difficult to manage. Instead of the more traditional approach of vascular reconstruction followed by transpubic end-to-end urethroplasty, these patients are better managed by up-front urethroplasty with a tubed flap or as a staged procedure with grafting and tubularization. Herein, we report a case of primary bulbar urethral ischemic necrosis due to pelvic fracture managed with tubularized preputial flap (McAninch flap) urethroplasty.
View Article and Find Full Text PDFManagement of Pelvic Fracture Urethral Injury: Is Supracrural Urethral Rerouting (Step 4) Becoming Anecdotical or Does It Remain in Force?
J Clin Med
March 2023
Department of Urology, Kulkarni Reconstructive Urology Center, Pune 411045, India.
Webster described a step-based perineal approach for repairing the posterior urethra in patients with pelvic fracture urethral injury (PFUI). The higher the complexity of the step, the higher the morbidity for the patient and the lower the surgical outcomes. We evaluated the outcomes of anastomotic urethroplasty (especially Step 4 or higher) or substitution urethroplasty in patients with PFUI at our center.
View Article and Find Full Text PDFArticle Synopsis
- The study analyzes pelvic fracture urethral injury (PFUI) in children and adolescents, examining various surgical techniques and their outcomes over an 11-year period.
- Patients included 192 children (181 boys and 11 girls), with an average age of 14 years for boys and 9 years for girls, and the results were broken down by gender and age group.
- The primary surgical technique used was transperineal anastomotic urethroplasty in boys, achieving an 81.2% overall success rate, while girls had a 100% success rate with the transpubic approach, and follow-up showed comparable success rates between age groups.
Is Anterior Plating Superior to the Bilateral Use of Retrograde Transpubic Screws for Treatment of Straddle Pelvic Ring Fractures? A Biomechanical Investigation.
J Clin Med
October 2021
Department for Trauma, Hand and Reconstructive Surgery, University Hospital, Albert-Schweitzer-Campus 1, Building W1, Waldeyerstraße 1, 48149 Münster, Germany.
Background: Fractures of the four anterior pubic rami are described as "straddle fractures". The aim of this study was to compare biomechanical anterior plating (group 1) versus the bilateral use of retrograde transpubic screws (group 2).
Methods: A straddle fracture was simulated in 16 artificial pelvises.
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