Early versus late surgical treatment of pelvic and acetabular fractures a five-year follow-up of 419 patients
Abstract Background Surgical treatment of pelvic and acetabular fractures is an advanced intervention with a high risk of subsequent complications. These patients are often polytrauma patients with multiple injuries in several organ systems. The optimal timing for the definitive surgery of these fra...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-023-06977-8 |
| _version_ | 1797647580511862784 |
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| author | Anders Enocson Natalie Lundin |
| author_facet | Anders Enocson Natalie Lundin |
| author_sort | Anders Enocson |
| collection | DOAJ |
| description | Abstract Background Surgical treatment of pelvic and acetabular fractures is an advanced intervention with a high risk of subsequent complications. These patients are often polytrauma patients with multiple injuries in several organ systems. The optimal timing for the definitive surgery of these fractures has been debated. The primary aim of this study was to investigate the influence of timing of definitive surgery on the rate of unplanned reoperations. Secondary aims included its influence on the occurrence of adverse events and mortality. Methods All patients from 18 years with a surgically treated pelvic or acetabular fracture operated at the Karolinska University Hospital in Sweden during 2010 to 2019 were identified and included. Data was collected through review of medical records and radiographs. Logistic regression analysis was performed to evaluate factors associated with unplanned reoperations and other adverse events. Results A total of 419 patients with definitive surgical treatment within 1 month of a pelvic (n = 191, 46%) or an acetabular (n = 228, 54%) fracture were included. The majority of the patients were males (n = 298, 71%) and the mean (SD, range) age was 53.3 (19, 18–94) years. A total of 194 (46%) patients had their surgery within 72 h (early surgery group), and 225 (54%) later than 72 h (late surgery group) after the injury. 95 patients (23%) had an unplanned reoperation. There was no difference in the reoperation rate between early (n = 44, 23%) and late (n = 51, 23%) surgery group (p = 1.0). A total of 148 patients (35%) had any kind of adverse event not requiring reoperation. The rate was 32% (n = 62) in the early, and 38% (n = 86) in the late surgery group (p = 0.2). When adjusting for relevant factors in regression analyses, no associations were found that increased the risk for reoperation or other adverse events. The 30-day mortality was 2.1% (n = 4) for the early and 2.2% (n = 5) for the late surgery group (p = 1.0). The 1-year mortality was 4.1% (n = 8) for the early and 7.6% (n = 17) for the late surgery group (p = 0.2). Conclusions Early (within 72 h) definitive surgery of patients with pelvic or acetabular fractures seems safe with regard to risk for reoperation, other adverse events and mortality. |
| first_indexed | 2024-03-11T15:18:35Z |
| format | Article |
| id | doaj.art-d32c850aeba340aba52277a74b25cebf |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-11T15:18:35Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-d32c850aeba340aba52277a74b25cebf2023-10-29T12:05:11ZengBMCBMC Musculoskeletal Disorders1471-24742023-10-012411710.1186/s12891-023-06977-8Early versus late surgical treatment of pelvic and acetabular fractures a five-year follow-up of 419 patientsAnders Enocson0Natalie Lundin1Department of Molecular Medicine and Surgery, Karolinska InstituteDepartment of Molecular Medicine and Surgery, Karolinska InstituteAbstract Background Surgical treatment of pelvic and acetabular fractures is an advanced intervention with a high risk of subsequent complications. These patients are often polytrauma patients with multiple injuries in several organ systems. The optimal timing for the definitive surgery of these fractures has been debated. The primary aim of this study was to investigate the influence of timing of definitive surgery on the rate of unplanned reoperations. Secondary aims included its influence on the occurrence of adverse events and mortality. Methods All patients from 18 years with a surgically treated pelvic or acetabular fracture operated at the Karolinska University Hospital in Sweden during 2010 to 2019 were identified and included. Data was collected through review of medical records and radiographs. Logistic regression analysis was performed to evaluate factors associated with unplanned reoperations and other adverse events. Results A total of 419 patients with definitive surgical treatment within 1 month of a pelvic (n = 191, 46%) or an acetabular (n = 228, 54%) fracture were included. The majority of the patients were males (n = 298, 71%) and the mean (SD, range) age was 53.3 (19, 18–94) years. A total of 194 (46%) patients had their surgery within 72 h (early surgery group), and 225 (54%) later than 72 h (late surgery group) after the injury. 95 patients (23%) had an unplanned reoperation. There was no difference in the reoperation rate between early (n = 44, 23%) and late (n = 51, 23%) surgery group (p = 1.0). A total of 148 patients (35%) had any kind of adverse event not requiring reoperation. The rate was 32% (n = 62) in the early, and 38% (n = 86) in the late surgery group (p = 0.2). When adjusting for relevant factors in regression analyses, no associations were found that increased the risk for reoperation or other adverse events. The 30-day mortality was 2.1% (n = 4) for the early and 2.2% (n = 5) for the late surgery group (p = 1.0). The 1-year mortality was 4.1% (n = 8) for the early and 7.6% (n = 17) for the late surgery group (p = 0.2). Conclusions Early (within 72 h) definitive surgery of patients with pelvic or acetabular fractures seems safe with regard to risk for reoperation, other adverse events and mortality.https://doi.org/10.1186/s12891-023-06977-8Pelvic fractureAcetabular fractureTraumaSurgical treatment |
| spellingShingle | Anders Enocson Natalie Lundin Early versus late surgical treatment of pelvic and acetabular fractures a five-year follow-up of 419 patients BMC Musculoskeletal Disorders Pelvic fracture Acetabular fracture Trauma Surgical treatment |
| title | Early versus late surgical treatment of pelvic and acetabular fractures a five-year follow-up of 419 patients |
| title_full | Early versus late surgical treatment of pelvic and acetabular fractures a five-year follow-up of 419 patients |
| title_fullStr | Early versus late surgical treatment of pelvic and acetabular fractures a five-year follow-up of 419 patients |
| title_full_unstemmed | Early versus late surgical treatment of pelvic and acetabular fractures a five-year follow-up of 419 patients |
| title_short | Early versus late surgical treatment of pelvic and acetabular fractures a five-year follow-up of 419 patients |
| title_sort | early versus late surgical treatment of pelvic and acetabular fractures a five year follow up of 419 patients |
| topic | Pelvic fracture Acetabular fracture Trauma Surgical treatment |
| url | https://doi.org/10.1186/s12891-023-06977-8 |
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