Urethral injury secondary to advanced fragility fracture of the pelvis: A case report

Fragility fracture of the pelvic ring (FFP) is rarely associated with urinary tract complications. We experienced a case of advanced FFP with urethral injury as late complications. The patient was an 83-year-old woman with no trauma episode who was admitted to our hospital due to acute groin pain. After several examinations, we diagnosed urethral rupture, urine leakage with bacterial contamination, urinary retention, and advanced FFP. We immediately performed cystostomy, puncture drainage for urine leakage, and antibiotic administration. Three weeks later, as the leakage and infection were controlled, internal fixation was performed for the FFP. Although she could walk alone with a cane at 1 year after the surgery, complete bone union was not achieved. This case was the advanced FFP complicated with urethral rupture, and the sequential treatments for each urinary retention, infection, and pelvic ring instability resulted in an acceptable outcome. Surgeons should recognize that chronic instability and repetitive friction in FFPs may be factors of urinary tract complications.