Bladder problems in pelvic injuries treated with external fixator and direct urethral drainage

Area of Science:

• Urology
• Trauma Surgery
• Orthopedic Surgery

Background:

• External fixators are increasingly used for unstable pelvic fractures, offering pain relief and early mobilization.
• Urethral catheter drainage is an alternative to open repair for ruptured bladders in critically injured patients.

Observation:

• This report details three cases of bladder complications associated with these management techniques.
• Two cases involved external fixators for pelvic fractures, and one involved urethral catheter drainage for bladder rupture.

Findings:

• Complications included transient hematuria due to bladder stretching over a bone fragment with external fixation.
• One case presented with the bladder wall trapped between pubic rami with external fixation.
• A pseudodiverticulum with a bone fragment projecting into the bladder occurred with catheter drainage in a patient with pubic rami fractures.

Implications:

• These cases highlight potential, though infrequent, bladder complications of current management strategies for pelvic fractures and bladder injuries.
• Awareness of these complications is crucial for clinicians employing these minimally invasive techniques.
• Further research may be needed to refine techniques and minimize risks associated with external fixators and catheter drainage.