Straddle Injuries

Straddle injuries occur when a person falls while straddling an object. They can be caused by blunt as well as penetrating injuries. The area injured can involve the soft tissues, external genitalia, urinary organs, or rectum. The trauma can be blunt, such as a landing upon the bar of a bicycle or the scaffolding at a construction site, or penetrating, such as being impaled by a sharp object. These injuries occur in both children and adults and in both males and females.

DIAGNOSIS

The examination of the patient and the history of trauma will often be all that is required. An X-ray may be needed. CT scans will help find bowel damage. A test of the urethra (retrograde urethrogram) may be done. This test uses dye to find any problems in the urethra (tube that carries urine) injuries. This test is usually done in males.

TREATMENT

The kind of injury will dictate the treatment needed:

  • Soft tissue injury resulting in a simple bruise (contusion) can be managed with cold compresses to reduce swelling. However, there may be urethral injury which could interfere with the passage of urine.

  • Penetrating injury may require immediate surgical intervention to:

  • Stop hemorrhage.

  • Provide drainage of accumulated urine and blood.

  • Realign the urethra.

  • Severe injuries, especially when there is pelvic bone fractures, may require immediate urinary drainage by insertion of a tube (suprapubic catheter). This catheter will drain the urine in the weeks or months it takes to repair the damage.

HOME CARE INSTRUCTIONS

Simple contusions may involve applying ice to the tender area for 15 to 20 minutes, 3 to 4 times per day, while awake for the first 2 days or as directed by your caregiver. Also, elevate the affected tissue, and rest. If more significant surgery was required for your injuries, your caregiver will provide instructions to you at the time of your discharge from the hospital. Following these instructions will maximize the likelihood of complete recovery in most cases.

SEEK MEDICAL CARE IF:

  • There is increased bruising, swelling, or pain.

  • Pain relief is not obtained with medication.

  • Your urine becomes bloody or blood tinged.

SEEK IMMEDIATE MEDICAL CARE IF:

  • There is increasing or severe pain.

  • There is difficulty starting your urine or if you cannot urinate.

  • You experience a temperature of 101.8° F (38.7° C) or greater or shaking chills and fever.