Yamakawa Yasuaki, Noda Tomoyuki, Saito Taichi, Saiga Kenta, Nakahara Ryuichi, Shimamura Yasunori, Ozaki Toshifumi
Department of Emergency Healthcare and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical science, Okayama, Japan.
Department of Musculoskeletal Traumatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan.
Trauma Case Rep. 2019 Feb 13;20:100169. doi: 10.1016/j.tcr.2019.100169. eCollection 2019 Apr.
The incidence rate of bladder rupture associated with pelvic ring fractures is reported to be about 5-10%, mostly occurring at the time of injury. Fragility pelvic ring fractures are reported to increase fracture displacement or become nonunion if they are treated inadequately. Few case reports on bladder rupture associated with fragility pelvic ring fracture have been published. We report a rare case of delayed bladder rupture associated with a fragility fracture of the pelvis. A 65-year-old female felt right hip pain without sustaining any trauma. She was diagnosed with a right pubic rami fracture. However, her pain deteriorated, and a sacral fracture was identified one month later. She was prescribed teriparatide, but her pain worsened and she was referred to our hospital. She was diagnosed with fragility fracture of the pelvis (Rommens classification type IVb) and was treated operatively. During the surgery, her thin bladder wall, which was compressed by a displaced pubic fragment, was torn and repaired. This is the first report describing a fragility fracture of the pelvis associated with a bladder rupture. Our treatment led to a successful result.
据报道,与骨盆环骨折相关的膀胱破裂发生率约为5%-10%,大多发生在受伤时。据报道,脆性骨盆环骨折若治疗不当会增加骨折移位或导致骨不连。关于脆性骨盆环骨折合并膀胱破裂的病例报告很少。我们报告一例罕见的与脆性骨盆骨折相关的延迟性膀胱破裂病例。一名65岁女性在未遭受任何外伤的情况下感到右髋疼痛。她被诊断为右侧耻骨支骨折。然而,她的疼痛加剧,1个月后发现骶骨骨折。她接受了特立帕肽治疗,但疼痛仍加重,随后被转诊至我院。她被诊断为骨盆脆性骨折(罗曼斯分类IVb型)并接受了手术治疗。手术过程中,她被移位的耻骨碎片压迫的薄膀胱壁被撕裂并进行了修复。这是第一例描述与膀胱破裂相关的骨盆脆性骨折的报告。我们的治疗取得了成功。