Intraoperative Diagnosis and Management of Testicular Dislocation During Pelvic Fracture Fixation: A Report of Two Cases and Literature Review

Background: Testicular dislocation due to trauma is a rare and frequently overlooked consequence of high-energy injuries, particularly those involving pelvic fractures. Early recognition is crucial to prevent complications, such as atrophy, infertility, or persistent discomfort. Case Report: We present two cases of right testicular dislocation managed intraoperatively during anterior Pfannenstiel approaches for reduction and fixation of unstable pelvic ring fractures (Tile C2 and B3) in male patients following motor vehicle accidents. Preoperative computed tomography scans revealed the ectopic location of the test is within the pelvic cavity. Urologic collaboration was obtained intraoperatively in both cases, allowing manual reduction and fixation by orchidopexy. Definitive fracture stabilization was achieved with anterior plating and iliosacral screws. Results: Both patients showed good urologic recovery. One developed a superficial wound infection that required surgical debridement, with favorable progression thereafter. Follow-up imaging demonstrated correct fracture consolidation in both cases. These cases underscore the need for systematic scrotal evaluation in male pelvic trauma patients. Conclusion: Traumatic testicular dislocation, though infrequent, should be considered in the evaluation of patients with pelvic trauma, especially when scrotal abnormalities or ambiguous imaging findings are present. Multidisciplinary management involving orthopedic and urologic teams allows appropriate treatment and reduces long-term risks. When well recognized during diagnosis, surgical correction can be performed effectively.