Management and outcome of pelvic fracture associated with vaginal injuries: a retrospective study of 25 cases

BACKGROUND: Pelvic ring fractures associated with vaginal injuries were rarely reported due to low incidence. The displaced segments of pelvic ring may increase the risk of vaginal injury. The aim of this retrospective study was to evaluate the correlation between pelvic fracture and vaginal injury. METHODS: We conducted a retrospective review of 25 patients with pelvic fractures associated with vaginal injury treated at our institution. The medical records of these patients were collected and 24 patients were followed-up for 10–36 months. RESULTS: All patients suffered anterior pelvic ring fracture. Young-Burgess fracture classification and compromised pubic symphysis were related to severity of vaginal injury. Gauze packing was done in 6 patients and 18 patients received surgical repair. Infection occurred in 6 patients, among them 4 were due to delayed diagnosis. Factors associated with pelvic outcome were age, urethral injury, and infection. Four patients suffered pain in sexual intercourse but no influence factor found correlated to sexual function. CONCLUSION: VS type pelvic fracture and compromised pubic symphysis were related to higher severity of vaginal injury. Disruption of anterior ring and an unstable pelvic ring caused by forces on coronary and axial plane may increase the risk of vaginal injury. TRIAL REGISTRATION: ChiCTR1900020540. Registered 28 January 2019. Retrospectively registered. Trial registry: Chinese Clinical Trial Registry.