Early urinary complications of fractures of the pelvis

The occurrence, relation to a particular type of fracture of the pelvis and the possible mechanism of early urinary complications were studied in 186 consecutive patients with fracture of the pelvis. Eighty-eight patients (47.3%) showed early urinary complications. These complications were minor in 73 patients (83.0%; 32.9% of all pelvic features) and major in 15 (17.0%; 8.1% of all pelvic fractures). The former comprised retention of urine in 41 patients (33.0%; 15.6% of all pelvic fractures), haematuria in 29 patients (33.0%; 15.6% of all pelvic fractures), and oliguria in three (3.4%; 1.6% of all pelvic fractures). The latter comprised rupture of the posterior urethra in nine patients (10.2%; 4.8% of all pelvic fractures), rupture of the bladder in five (5.7%; 2.7; of all pelvic fractures), and combined injury to the bladder and posterior urethra in one (1.1%; 0.5% of all pelvic fractures). These complications were common in relation to run-over and collision accidents. The common pelvic fracture encountered in these patients was the Type III and the individual pelvic fracture was that of both pubic rami on one or both sides; fractures of the acetabulum and posterior segment of the pelvis were next in frequency. On the other hand, fractures of a single ischial ramus or wing of the ilium were not commonly encountered. Fractures with intact pelvic ring were associated with only 9.1% of these complications; all were minor.