Reza Firoozabadi1, Milton Little, Timothy Alton, John Scolaro, Julie Agel, Mathew Kogut. 1. *Department of Orthopedic Surgery and Sports Medicine, Harborview Medical Center, Seattle, WA; †Department of Orthopedic Surgery, Cedar Sinai Medical Center, Los Angeles, CA; ‡Department of Orthopedic Surgery, University of California-Irvine, Orange County, CA; and §Department of Interventional Radiology, Harborview Medical Center, Seattle, WA.
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.
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.
Authors: Kyle H Cichos; Khalid H Mahmoud; Clay A Spitler; Ahmed M Kamel Abdel Aal; Sarah Osman; Gerald McGwin; Elie S Ghanem Journal: Clin Orthop Relat Res Date: 2020-08 Impact factor: 4.755