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Certain pelvic fracture patterns are more likely to cause urethral injury in men who suffer blunt trauma

Urethral injury is a rare but serious condition that can include infection, bleeding, incontinence, erectile dysfunction, and infertility in men. Most urethral injuries are due to pelvic fractures in men, yet only 5 to 10 percent of pelvic fractures result in urethral injuries. Disruption of the anterior pelvic arch, specifically pubic symphysis diastasis and displaced inferomedial pubic bone fractures, are the pelvic fracture patterns most likely to cause urethral injury, according to a new study.

Researchers found that 92 percent of men with pelvic fracture and urethral injury had specific inferomedial pubic bone fractures or pubic symphysis diastasis. Also, 88 percent had injuries to these regions that displaced the pelvic bone by 1 cm or more.

Recognition of these specific pelvic bone injury sites can aid urologists and trauma doctors in identifying men at risk for urethral injury due to blunt trauma, note C. Craig Blackmore, M.D., M.P.H., and colleagues at Harborview Medical Center, University of Washington. They retrospectively studied 119 male patients with pelvic fracture, who were evaluated at a trauma center between 1997 and 2003. The researchers used computerized tomography and pelvic radiographs to determine associations between specific fracture locations and urethral injury. They controlled for age, injury mechanism (43 percent of fractures were caused by motor vehicle collisions), injury severity, and direction of blunt trauma force.

More details are in "Predicting urethral injury from pelvic fracture patterns in male patients with blunt trauma," by Amaya M. Basta, Dr. Blackmore, and Hunter Wessells, M.D., in the February 2007 Journal of Urology 177, pp. 571-575.

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