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骨盆骨折合并阴道损伤的处理和结局:25 例回顾性研究。

Management and outcome of pelvic fracture associated with vaginal injuries: a retrospective study of 25 cases.

机构信息

Department of Orthopedic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan, Shandong, China.

出版信息

BMC Musculoskelet Disord. 2019 Oct 22;20(1):466. doi: 10.1186/s12891-019-2839-y.

Abstract

BACKGROUND

Pelvic ring fractures associated with vaginal injuries were rarely reported due to low incidence. The displaced segments of pelvic ring may increase the risk of vaginal injury. The aim of this retrospective study was to evaluate the correlation between pelvic fracture and vaginal injury.

METHODS

We conducted a retrospective review of 25 patients with pelvic fractures associated with vaginal injury treated at our institution. The medical records of these patients were collected and 24 patients were followed-up for 10-36 months.

RESULTS

All patients suffered anterior pelvic ring fracture. Young-Burgess fracture classification and compromised pubic symphysis were related to severity of vaginal injury. Gauze packing was done in 6 patients and 18 patients received surgical repair. Infection occurred in 6 patients, among them 4 were due to delayed diagnosis. Factors associated with pelvic outcome were age, urethral injury, and infection. Four patients suffered pain in sexual intercourse but no influence factor found correlated to sexual function.

CONCLUSION

VS type pelvic fracture and compromised pubic symphysis were related to higher severity of vaginal injury. Disruption of anterior ring and an unstable pelvic ring caused by forces on coronary and axial plane may increase the risk of vaginal injury.

TRIAL REGISTRATION

ChiCTR1900020540 . Registered 28 January 2019. Retrospectively registered.

TRIAL REGISTRY

Chinese Clinical Trial Registry.

摘要

背景

由于发病率低,与阴道损伤相关的骨盆环骨折很少见。骨盆环移位的节段可能会增加阴道损伤的风险。本回顾性研究旨在评估骨盆骨折与阴道损伤之间的相关性。

方法

我们对我院收治的 25 例骨盆骨折合并阴道损伤患者进行了回顾性研究。收集了这些患者的病历资料,对 24 例患者进行了 10-36 个月的随访。

结果

所有患者均发生前骨盆环骨折。Young-Burgess 骨折分型和耻骨联合受损与阴道损伤的严重程度有关。6 例患者行纱布填塞,18 例患者行手术修复。6 例患者发生感染,其中 4 例因诊断延迟。与骨盆预后相关的因素是年龄、尿道损伤和感染。4 例患者性交时疼痛,但未发现与性功能相关的影响因素。

结论

VS 型骨盆骨折和耻骨联合受损与阴道损伤的严重程度较高有关。冠状面和轴面的外力会破坏前环和不稳定的骨盆环,从而增加阴道损伤的风险。

试验注册

ChiCTR1900020540。注册于 2019 年 1 月 28 日。回顾性注册。

试验注册机构

中国临床试验注册中心。

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