Association of Pelvic Trauma With Rates of Cesarean Section, Sexual Dysfunction, and Genitourinary Dysfunction in a...

Area of Science:

• Orthopaedic Surgery
• Women's Health
• Trauma Outcomes

Background:

• Pelvic fractures significantly impact women's quality of life, potentially causing sexual dysfunction (SD), genitourinary dysfunction (GD), and increasing the need for cesarean sections (C-sections).
• Long-term outcomes following pelvic fractures in women of childbearing age are under-researched.

Purpose of the Study:

• To investigate the association between pelvic fractures and the rates of C-section, SD, and GD in women of childbearing age.
• To compare these outcomes with a control group of patients with lower extremity long-bone fractures.

Main Methods:

• Retrospective analysis of a national insurance database identifying women of childbearing age with pelvic fractures.
• Comparison with a cohort of patients sustaining lower extremity long-bone fractures, requiring a minimum 5-year follow-up.
• Multivariate logistic regression analysis adjusted for diabetes, tobacco use, hypertension, obesity, and advanced maternal age.

Main Results:

• Patients with pelvic fractures showed significantly higher rates of C-section (50.0% vs. 38.8%), SD diagnosis (10.9% vs. 8.8%), and urinary retention (3.5% vs. 2.8%) compared to controls.
• Pelvic fracture was independently associated with increased odds of C-section (OR: 1.78), SD (OR: 1.23), and urinary retention (OR: 1.35).
• No significant difference in global genitourinary dysfunction diagnosis was observed between the groups.

Conclusions:

• Pelvic fractures are linked to an elevated intrinsic risk of C-section, sexual dysfunction, and urinary retention.
• These risks exceed those associated with traumatic lower extremity injuries.
• Orthopaedic surgeons should counsel patients on these potential long-term sequelae and facilitate interspecialty care.