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Journal of the Korean Society of Traumatology 2007;20(2):90-95.
Relation between Location of Pelvic bone Fractures and the Injury to the Urinary bladder, Urethra or Lower gastrointestinal tract
Chang Ho Kim, Jung Bae Park, Hyun Wook Ryoo, Kang Suk Seo, Jun Seok Seo, Jae Myung Chung, Dong Wook Je, Ae Jin Sung
1Department of Emergency Medicine, College of Medicine, Kyungpook National University, Daegu, Korea. jbpark@knu.ac.kr
2Daegu Emergency Medical Information Center, Daegu, Korea.
골반 골절 위치와 방광, 요도, 하부 위장관계 손상의 관련성
경북대학교 의과대학 응급의학교실, 대구응급의료정보센터*
This research was conducted to study whether the specific location of pelvic-bone fractures could increase the risk for injury to the urinary bladder, urethra, or lower gastrointestinal tract.
We retrospectively reviewed the data of 234 patients with pelvic-bone fractures who visited the emergency department of Kyungpook National University Hospital from January 2004 to December 2006. The location of the pelvic-bone fracture was divided into 8 parts. The association of fracture location with injury to the urinary bladder, urethra, or lower gastrointestinal tract was analyzed with Fisher's-exact test and multiple logistic regression.
Nineteen(19) patients had urinary bladder injury, 8 had urethral injury, and 9 had lower gastrointestinal tract injury. The following fracture locations were found to be significant; urinary bladder: sacroiliac (SI) joint (p<0.001), symphysis pubis (p=0.011), and sacrum (p=0.005); urethra: SI joint (p=0.020); lower gastrointestinal tract: symphysis pubis (p=0.028). After the multiple logistic regression analysis, the primary and the independent predictors for each of the injuries were as follows; urinary bladder: sacroiliac joint (p=0.000, odds ratio [OR]=10.469); lower gastrointestinal tract: symphysis pubis (p=0.037, OR=7.009).
Consideration of further workup for injuries to the lower gastrointestinal and urinary tract is needed for some locations of pelvic-bone fractures because certain pelvic-bone fracture locations, especially the sacroiliac joint and the symphysis pubis, are associated with increased risk for injury to the lower gastrointestinal and urinary tracts.
Key Words: Urinary bladder; Urethra; Lower gastrointestinal tract; Pelvic bone; Fracture
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