Does Pelvic Embolization Increase Infection Rates in Patients Who Undergo Open Treatment of Acetabular Fractures?

J Orthop Trauma. 2017 Apr;31(4):185-188. doi: 10.1097/BOT.0000000000000771.

Abstract

Objective: Evaluate the impact of pelvic embolization on postoperative infection rate after acetabular fracture fixation.

Design: Retrospective study of 3 separate cohorts.

Setting: Level I Trauma Center.

Patients/participants: Identified patients who underwent angiography of the pelvis as well as required an open reduction internal fixation (ORIF) of an acetabular fracture. This group was compared to a control group of patients with an acetabular fracture, which did not undergo angiography, and underwent ORIF.

Intervention: ORIF of an aectabular fracture with angiography ± embolization.

Main outcome measurements: Deep infection rate.

Results: Seventy-two patients remained for final analysis; 25 patients underwent embolization, 16 patients underwent angiography without embolization, and 31 patients did not undergo angiography. Two out of 25 (8%) patients developed infections in the embolization group, one deep infection and one superficial infection. Five out of 16 (31%) patients developed deep infections in the nonembolization group. Control group of patients who did not undergo angiography had a deep infection rate of 9.6%.

Conclusion: Despite previous reports of high infection rates after pelvic embolization, the deep infection rate was only 4% after embolization in our cohort. This suggests that concerns for higher rates of infection are not substantiated, and pelvic embolization should be performed when indicated.

Level of evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

MeSH terms

  • Acetabulum / injuries*
  • Acetabulum / surgery*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Causality
  • Embolization, Therapeutic / statistics & numerical data*
  • Female
  • Fractures, Bone / epidemiology*
  • Fractures, Bone / surgery*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Open Fracture Reduction / statistics & numerical data*
  • Pelvis
  • Postoperative Hemorrhage / epidemiology
  • Postoperative Hemorrhage / prevention & control
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / epidemiology*
  • Treatment Outcome
  • Washington / epidemiology
  • Young Adult