• Arch Orthop Trauma Surg · May 2021

    Case Reports

    Single stage reconstruction of a neglected open book pelvic injury with bladder herniation into the upper thigh: a case-report.

    • Michiel Herteleer, Joachim Thüroff, and Pol Maria Rommens.
    • Zentrum für Orthopädie und Unfallchirurgie, Universitätsmedizin Mainz, Langenbeckstraße 1, 55131, Mainz, Germany. michielherteleer@me.com.
    • Arch Orthop Trauma Surg. 2021 May 1; 141 (5): 855859855-859.

    AbstractWhen open-book injuries are neglected and result into a pelvic malunion or nonunion, long-term problems, such as chronic pain, gait abnormalities, sitting discomfort, neurological symptoms and urogenital symptoms can occur. In this case report, we describe the repair of a neglected pelvic disruption with the dislocation of the urinary bladder in a one-stage procedure. The clinical image with which the patient presented could be split into unique sub-problems, for which separate solutions needed to be chosen: large symphysis diastasis, instability and pain in both SI joints, malunion of the superior and inferior pubic rami fractures; and urinary bladder herniation into the upper thigh. In a single-stage procedure, the pelvic ring was reconstructed and the bladder reduced. The patient was thereafter continent for urine and could walk independently. A complex clinical problem was divided into its sub-problems, for which specific solutions were found.

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