Weissbach L, Klammer H L
Urologe A. 1976 May;15(3):118-21.
The combined injury-rupture of the urethra and the symphysis--is no respecter of the surgical disciplines, urology and accident surgery. Therefore, a combined operating team from both specialties should simultaneously undertake primary care. First comes the restoration of urethral continuity. The retropubic approach favors the gaping pubic symphysis. A stationary osteosynthesis of the symphysis with an AO-tension band plate follows. In that way the urethra and its suspension apparatus are brought into the right position. Immobilization damage is avoided through exercise stability which allows early maximum stress of the patient. A persisting instability of the anterior pelvic girdle through shearing force is a risk in reconstructive urethral surgery. Simultaneous primary care is contraindicated in cases of irreversible shock and life-threatening injury where the need for surgery is urgent.
尿道与耻骨联合的联合损伤与断裂——不分泌尿外科和创伤外科这两个外科学科。因此,来自这两个专科的联合手术团队应同时进行初步处理。首先是恢复尿道连续性。耻骨后入路有利于耻骨联合分离。随后用AO张力带钢板对耻骨联合进行稳定的骨固定。这样可使尿道及其悬吊装置处于正确位置。通过运动稳定性避免固定损伤,这能让患者尽早承受最大应力。在重建性尿道手术中,耻骨前骨盆环因剪切力持续不稳定是一种风险。在不可逆休克和危及生命的损伤且急需手术的情况下,禁忌同时进行初步处理。