Relationship of the patterns of pelvic bone fracture and bladder rupture

Choi, Hwan Sik; Hong, Jong Woo; Kang, Sang Jae; Shin, Se Jong

Abstract

A clinical observation was made on 64 cases of the bladder rupture who were admitted to our hospital during the period from June, 1979 to February, 1991. The results are as following ; 1. Of 355 cases of the genitourinary tract injury, the bladder rupture were 64 cases (18.0%), which were composed of 40 cases (62.5%) of bladder rupture without pelvic bone fracture and 24 cases (37.5%) of bladder rupture with pelvic bone fracture. The bladder rupture without pelvic bone fracture were composed of 35 cases (87.5%) with intraperitoneal bladder rupture and 5 cases (12.5%) with extraperitoneal bladder rupture, the bladder rupture with pelvic bone fracture were composed of 13 cases (12.5%) with intra and extraperitoneal bladder rupture. 2. In 24 patients with pelvic bone fracture, the most common site of bladder ruptures were found on the lateral wall in 12 cases (50%), and followed by the dome in 9 cases (37.5%), multiple areas in 3 cases (12.5%). In 40 patients without pelvic bone fracture, the most common site of bladder ruptures were found on the dome in 33 cases (82.5%), and followed by the multiple areas in 4 cases (10%), lateral wall in 3 cases (7.5%). 3. The average size of the bladder rupture was 6.5cm in cases without pelvic bone fracture, 6. 8cm in cases with pelvic bone fracture, especially comminuted pelvic ring fracture had most severed bladder rupture (average; 8.3cm). 4. Of 24 pelvic bone fractures, pubic rami fractures were most common (41.6%), and followed by comminuted pelvic ring fracture (25%), anterior and posterior pelvic ring fractures (12.5%), acetabulum and isolated fractures (8.3%), symphyseal separation fractures (4.1%) in order of frequency. 5. 5 cases (20%) of pelvic bone fractures were associated with posterior urethral injury, especially 60% in The pubic rami fracture. There was no significant relation between the type of pelvic fracture and the type of bladder rupture, but the fractures involving pubic arch were more often associated with posterior urethral injury.