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Spontaneous urinary voiding of a metallic implant after operative fixation of the pubic symphysis.

Displaced fractures and dislocations of the pelvic ring and acetabulum are usually treated with open reduction and internal fixation with a plate and screws. Loosening and migration of these plates can occur; however, to the best of our knowledge, we are the first to describe the migration of such implants into the urinary tract through the bladder wall. We report the case of a patient who experienced late migration of a screw and washer into the bladder with spontaneous voiding of the screw.

In September 1992, a twenty-five-year-old man was brought to the emergency room of the Hospital Sao Lucas, Pontificia Universidade Catolica do Rio Grande do Sul—PUCRS, in Porto Alegre, Brazil, after being run over by an automobile. The patient underwent exploratory laparotomy for a hemoperitoneum, and a splenectomy was performed. No evidence of bladder injury was noted. Skeletal traction was applied to the right lower extremity because of a transverse fracture of the right acetabulum, which was associated with disruption of the pubic symphysis and the left sacroiliac joint ( Fig. 1 ). Two weeks later, after clinical stabilization of the patient, the right hip was explored through a Kocher-Langenbeck approach with an osteotomy of the greater trochanter. Multiple bone fragments were extracted from the joint, but the acetabular fracture could not be satisfactorily reduced. One week later, through an …