Purpose Post-operative complications following fixation of pelvic fractures can lead to mortality and increased morbidity. Available literature regarding complications is heterogeneous and... Show morePurpose Post-operative complications following fixation of pelvic fractures can lead to mortality and increased morbidity. Available literature regarding complications is heterogeneous and knowledge on risk factors is limited. This study aims to identify the most common post-operative complications and their possible risk factors following pelvic fracture surgery. Methods A retrospective cohort study was performed in two level-1 trauma centers in the Netherlands between January 2015 and January 2021. Included patients were all adult patients (>= 18 years) with an operatively treated pelvic fracture (pelvic ring and/or acetabular fractures). Post-operative complications included surgical site infections (SSI), material-related complications, neurological complications, malunion/non-union and performed reoperations. A forward stepwise multivariable logistic regression analysis was used to identify any risk factors associated with these complications. Results Complications occurred in 55 (24%) of the 233 included patients. SSI's were most common, occurring in 34 (15%) patients. Duration of surgery (odds ratio 1.01 per minute, 95% confidence interval 1.00-1.01) and obesity (odds ratio 1.10 per BMI point, 95% confidence interval 1.29-7.52) were independent risk factors for development of SSI. Less common post-operative complications were material-related complications (8%) and neurological damage (5%). Conclusion Limiting operation time by using less invasive and less time-consuming surgical approaches may reduce the risk of SSI. More awareness and post-operative screening for early signs of SSI is mandatory, especially in obese patients. Future research should include large prospective patient cohorts to determine risk factors for other post-operative complications associated with pelvic fracture surgery. Show less
Luijt, P.A. van; Schipper, I.B.; Egmond, P.W. van 2012
PURPOSE: Worldwide, many displaced distal forearm fractures in children are treated by closed reduction under local anesthesia and cast immobilization. If mal-alignment of the fracture persists... Show morePURPOSE: Worldwide, many displaced distal forearm fractures in children are treated by closed reduction under local anesthesia and cast immobilization. If mal-alignment of the fracture persists after initial reduction attempt, final fracture reduction will be performed under general anesthesia, followed by cast immobilization. The purpose of this study was to analyze the results of minimally invasive fixation with K-Wire or ESIN after fracture reduction in children under general anesthesia, compared with the results of closed reduction and plaster immobilization. We hypothesize that primary percutaneous fixation prevents secondary redisplacement and reduces the number of secondary interventions. METHODS: All skeletally immature children who sustained a distal forearm fracture, and treated under general anesthesia in the operation room (OR), were included. The patients were analyzed according to three treatment groups and fracture type. The primary outcome measure was the number of patients who required a second procedure of fracture reduction after initial treatment. RESULTS: A considerable amount of children with displaced distal forearm fractures treated by closed reduction and cast immobilization show loss of reduction and require secondary reduction (43.7%). After closed reduction with primary internal fixation, with minimally invasive techniques such as K-wires or ESIN, secondary loss of reduction did not occur. CONCLUSIONS: Additional internal fixation after reduction of a forearm fracture minimizes the secondary displacement risk and the subsequent risk of a re-intervention. Therefore, primary minimal invasive fixation of displaced distal forearm fractures after closed reduction under general anesthesia seems preferable to closed reduction only and is strongly recommended as the preferred treatment strategy. Show less
