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Extraperitoneal Bladder Injuries Associated With Pelvic Fracture Requiring Internal Fixation: What Is the Evidence?

Abstract
Traumatic bladder injuries are commonly associated with pelvic fractures. While the majority of intraperitoneal bladder injuries are surgically repaired, extraperitoneal bladder injuries (EBIs) can be managed nonoperatively in the absence of complex injury patterns such as bladder neck injury or presence of bone spicules in the bladder. Concern for pelvic hardware contamination is one of the most common reasons for repairing EBIs at the time of orthopedic interventions for pelvic fracture (usually open reduction and internal fixation). However, given the inconsistent and limited evidence, practice patterns are different and largely depend on surgeon preferences and institutional management. In this review, we explore the roots for this concern and summarize the current evidence on risk of pelvic hardware infection with nonoperative management of EBIs.
AuthorsSeyyed Saeed Khabiri, Sorena Keihani, Jeremy B Myers
JournalThe American surgeon (Am Surg) Vol. 87 Issue 8 Pg. 1203-1206 (Aug 2021) ISSN: 1555-9823 [Electronic] United States
PMID33350852 (Publication Type: Journal Article, Review)
Topics
  • Equipment Contamination
  • Evidence-Based Medicine
  • Fracture Fixation, Internal (adverse effects, instrumentation)
  • Fractures, Bone (complications, surgery)
  • Humans
  • Open Fracture Reduction
  • Pelvic Bones (injuries, surgery)
  • Risk Factors
  • Surgical Wound Infection
  • Urinary Bladder (injuries)

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