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Infection, fixation failure considered indicators of reoperation in pelvic fractures
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NATIONAL HARBOR, Md. — Infection and fixation failure in operatively treated pelvic ring injuries were the most common indicators of unplanned reoperation, according to a study results presented here at the Orthopaedic Trauma Association Annual Meeting.
George Ochenjele, MD, and his colleagues reviewed the medical records of 913 patients who had operatively treated pelvic ring injuries within a 12-year time period. The primary endpoint of the study was to measure unplanned index reoperation for infection, fixation, failure, heterotopic ossification and bleeding complication.
“We looked at various injury characteristics ranging from injury severity, mechanism of injury and other associated injuries, such as open fracture and associated acetabular fractures,” he said. “For treatment factors, we were interested in looking at various factors that might influence reoperation.”
According to Ochenjele, the overall rate of reoperation was 14.6%, with a reoperation rate of 8.1% for infection, 5.7% for fixation failure, less than 1% for heterotopic ossification and less than 1% for bleeding complication.
Mean occurrence for reoperation was 19 days for infection and 22 days for fixation failure.
“Our hypothesis held through in the fact that we thought that reoperation would happen early. Fixation failure and infection, as an indication for reoperation, all occurred within 1 month of postoperative period,” he said.
In addition, the researchers identified four independent predictors of reoperation, which were open fractures, combined pelvic ring and acetabular injuries, abdominal viscera injuries and increasing Young-Burgess pelvic fracture grade.
No independent association was found between reoperation and patient, treatment and any other injury factors (P > .20).
“We believe our findings will be helpful with risk assessment and discussions with patients. The limitation [of the study] is that this is a single institution study. However, it is a very large series of patients with multiple surgeons treating these patients over an extended period of time,” Ochenjele said. – by Nhu Te
Reference:
Ochenjele G. Paper #54. Presented at: Orthopaedic Trauma Association Annual Meeting; Oct. 5-8, 2016; National Harbor, Md.
Disclosure: Ochenjele reports no relevant financial disclosures.