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Factors Associated With Infection in Patients With Combined Pelvic Ring and Bladder Injuries.

Nathan P Olszewski1, Joseph Sliepka2, Joseph J Bigham2

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Journal of Orthopaedic Trauma
|August 16, 2024
PubMed
Summary
This summary is machine-generated.

Open reduction and internal fixation for pelvic ring and bladder injuries shows a low infection rate. Combined intraperitoneal and extraperitoneal bladder injuries increase infection risk in these patients.

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Area of Science:

  • Trauma Surgery
  • Orthopedic Surgery
  • Urology

Background:

  • Combined pelvic ring and bladder injuries present complex management challenges.
  • Infection is a significant complication following surgical treatment of these injuries.

Purpose of the Study:

  • To determine the infection rate in patients with combined pelvic ring and bladder injuries.
  • To identify treatment and injury factors associated with infection risk.

Main Methods:

  • Retrospective review of 106 patients over a 12-year period.
  • Inclusion criteria: combined pelvic ring and bladder injuries, anterior pelvic stabilization, and follow-up >= 90 days.
  • Exclusion criteria: nonoperative management, isolated posterior fixation.

Main Results:

  • Overall deep infection rate was 6.6% (7/106) requiring surgical debridement.
  • Open reduction and internal fixation with plating and acute bladder repair had a 2.2% infection rate.
  • Closed reduction with external fixation or percutaneous screws had a 17.6% infection rate.
  • Combined intraperitoneal and extraperitoneal bladder injuries had a significantly higher infection rate (23%) compared to isolated injuries (P=0.029).

Conclusions:

  • Acute open reduction and internal fixation of the anterior pelvis is associated with a low infection rate in patients with combined pelvic ring and bladder injuries.
  • Patients with combined intraperitoneal and extraperitoneal bladder injuries face an elevated risk of infection.