Does Anterior Plating of Pelvic Ring Fractures Increase Infection Risk in Patients With Bladder or Urethral Injuries? (2024)

the EMIT Pelvic Fracture Study Group (2024). Does Anterior Plating of Pelvic Ring Fractures Increase Infection Risk in Patients With Bladder or Urethral Injuries? Journal of orthopaedic trauma, 38(3), 129-133. https://doi.org/10.1097/BOT.0000000000002745

the EMIT Pelvic Fracture Study Group. / Does Anterior Plating of Pelvic Ring Fractures Increase Infection Risk in Patients With Bladder or Urethral Injuries?. In: Journal of orthopaedic trauma. 2024 ; Vol. 38, No. 3. pp. 129-133.

@article{4eac903176c443489e4c610f8970f35f,

title = "Does Anterior Plating of Pelvic Ring Fractures Increase Infection Risk in Patients With Bladder or Urethral Injuries?",

abstract = "OBJECTIVES:Evaluate the effect of anterior fixation on infection in patients with operative pelvic fractures and bladder or urethral injuries.METHODS:Design:Retrospective.Setting:Eight centers.Patient Selection Criteria:Adult patients with closed pelvic fractures with associated bladder or urethral injuries treated with anterior plating (AP), intramedullary screw (IS), or no anterior internal fixation (NAIF, including external fixation or no fixation).Outcome Measures and Comparisons:Deep infection.RESULTS:There were 81 extraperitoneal injuries and 57 urethral injuries. There was no difference in infection between fixation groups across all urologic injuries (AP: 10.8%, IS: 0%, NAIF: 4.9%, P = 0.41). There was a higher rate of infection in the urethral injury group compared with extraperitoneal injuries (14.0% vs. 2.5%, P = 0.016). Among extraperitoneal injuries, specifically, there was no difference in deep infection related to fixation (AP: 2.6%, IS 0%, NAIF: 2.9%, P = 0.99). Among urethral injuries, there was no statistical difference in deep infection related to fixation (AP: 23.1%, IS: 0%, NAIF: 7.4%, P = 0.21). There was a higher rate of suprapubic catheter (SPC) use in urethral injuries compared with extraperitoneal injuries (57.9% vs. 4.9%, P < 0.0001). In the urethral injury group, SPC use did not have a statistically significant difference in infection rate (SPC: 18.2% vs. No SPC: 8.3%, P = 0.45). Early removal of the SPC before or during the definitive orthopaedic intervention did not significantly affect infection rate (early: 0% vs. delayed: 25.0%, P = 0.16).CONCLUSIONS:Surgeons should approach operative pelvic fractures with associated urologic injuries with caution given the high risk of infection. Further work must be done to elucidate the effect of anterior implants and SPC use and duration.LEVEL OF EVIDENCE:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.",

keywords = "anterior pelvis plate fixation, bladder injury, pelvic fracture, urethral injury",

author = "{the EMIT Pelvic Fracture Study Group} and Suman Medda and Mario Cuadra and Ziqing Yu and Givenchy Manzano and Clay Spitler and Paul Matuszewski and David Patch and Tyler Pease and Andrew Chen and Victoria Garrard and Madhav Karunakar and Nicholas Andring and Benjamin Averkamp and Sharon Babco*ck and Kayla Bell and Lucy Bowers and Eben Carroll and Christine Churchill and Madison Colcord and Patrick Curtin and Erica Grochowski and Jason Halvorson and Kate Hickson and Zachery Hong and Laurence Kempton and Thea Lance and Natalie Marenghi and Mayberry, {Robert Miles} and Anna Miller and Alysa Nash and Virgenal Owens and Jeremiah Parham and Kevin Phelps and Holly Pilson and Hannah Pollock and Madeline Rieker and Tamar Roomian and Owen Ross and Rachel Seymour and Stephen Sims and Juliette Sweeney and Yin, {Timothy C.} and Catherine Young",

note = "Publisher Copyright: {\textcopyright} 2024 Wolters Kluwer Health. All rights reserved.",

year = "2024",

month = mar,

day = "1",

doi = "10.1097/BOT.0000000000002745",

language = "English",

volume = "38",

pages = "129--133",

journal = "Journal of orthopaedic trauma",

issn = "0890-5339",

number = "3",

}

the EMIT Pelvic Fracture Study Group 2024, 'Does Anterior Plating of Pelvic Ring Fractures Increase Infection Risk in Patients With Bladder or Urethral Injuries?', Journal of orthopaedic trauma, vol. 38, no. 3, pp. 129-133. https://doi.org/10.1097/BOT.0000000000002745

Does Anterior Plating of Pelvic Ring Fractures Increase Infection Risk in Patients With Bladder or Urethral Injuries? / the EMIT Pelvic Fracture Study Group.
In: Journal of orthopaedic trauma, Vol. 38, No. 3, 01.03.2024, p. 129-133.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Does Anterior Plating of Pelvic Ring Fractures Increase Infection Risk in Patients With Bladder or Urethral Injuries?

AU - the EMIT Pelvic Fracture Study Group

AU - Medda, Suman

AU - Cuadra, Mario

AU - Yu, Ziqing

AU - Manzano, Givenchy

AU - Spitler, Clay

AU - Matuszewski, Paul

AU - Patch, David

AU - Pease, Tyler

AU - Chen, Andrew

AU - Garrard, Victoria

AU - Karunakar, Madhav

AU - Andring, Nicholas

AU - Averkamp, Benjamin

AU - Babco*ck, Sharon

AU - Bell, Kayla

AU - Bowers, Lucy

AU - Carroll, Eben

AU - Churchill, Christine

AU - Colcord, Madison

AU - Curtin, Patrick

AU - Grochowski, Erica

AU - Halvorson, Jason

AU - Hickson, Kate

AU - Hong, Zachery

AU - Kempton, Laurence

AU - Lance, Thea

AU - Marenghi, Natalie

AU - Mayberry, Robert Miles

AU - Miller, Anna

AU - Nash, Alysa

AU - Owens, Virgenal

AU - Parham, Jeremiah

AU - Phelps, Kevin

AU - Pilson, Holly

AU - Pollock, Hannah

AU - Rieker, Madeline

AU - Roomian, Tamar

AU - Ross, Owen

AU - Seymour, Rachel

AU - Sims, Stephen

AU - Sweeney, Juliette

AU - Yin, Timothy C.

AU - Young, Catherine

N1 - Publisher Copyright:© 2024 Wolters Kluwer Health. All rights reserved.

PY - 2024/3/1

Y1 - 2024/3/1

N2 - OBJECTIVES:Evaluate the effect of anterior fixation on infection in patients with operative pelvic fractures and bladder or urethral injuries.METHODS:Design:Retrospective.Setting:Eight centers.Patient Selection Criteria:Adult patients with closed pelvic fractures with associated bladder or urethral injuries treated with anterior plating (AP), intramedullary screw (IS), or no anterior internal fixation (NAIF, including external fixation or no fixation).Outcome Measures and Comparisons:Deep infection.RESULTS:There were 81 extraperitoneal injuries and 57 urethral injuries. There was no difference in infection between fixation groups across all urologic injuries (AP: 10.8%, IS: 0%, NAIF: 4.9%, P = 0.41). There was a higher rate of infection in the urethral injury group compared with extraperitoneal injuries (14.0% vs. 2.5%, P = 0.016). Among extraperitoneal injuries, specifically, there was no difference in deep infection related to fixation (AP: 2.6%, IS 0%, NAIF: 2.9%, P = 0.99). Among urethral injuries, there was no statistical difference in deep infection related to fixation (AP: 23.1%, IS: 0%, NAIF: 7.4%, P = 0.21). There was a higher rate of suprapubic catheter (SPC) use in urethral injuries compared with extraperitoneal injuries (57.9% vs. 4.9%, P < 0.0001). In the urethral injury group, SPC use did not have a statistically significant difference in infection rate (SPC: 18.2% vs. No SPC: 8.3%, P = 0.45). Early removal of the SPC before or during the definitive orthopaedic intervention did not significantly affect infection rate (early: 0% vs. delayed: 25.0%, P = 0.16).CONCLUSIONS:Surgeons should approach operative pelvic fractures with associated urologic injuries with caution given the high risk of infection. Further work must be done to elucidate the effect of anterior implants and SPC use and duration.LEVEL OF EVIDENCE:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

AB - OBJECTIVES:Evaluate the effect of anterior fixation on infection in patients with operative pelvic fractures and bladder or urethral injuries.METHODS:Design:Retrospective.Setting:Eight centers.Patient Selection Criteria:Adult patients with closed pelvic fractures with associated bladder or urethral injuries treated with anterior plating (AP), intramedullary screw (IS), or no anterior internal fixation (NAIF, including external fixation or no fixation).Outcome Measures and Comparisons:Deep infection.RESULTS:There were 81 extraperitoneal injuries and 57 urethral injuries. There was no difference in infection between fixation groups across all urologic injuries (AP: 10.8%, IS: 0%, NAIF: 4.9%, P = 0.41). There was a higher rate of infection in the urethral injury group compared with extraperitoneal injuries (14.0% vs. 2.5%, P = 0.016). Among extraperitoneal injuries, specifically, there was no difference in deep infection related to fixation (AP: 2.6%, IS 0%, NAIF: 2.9%, P = 0.99). Among urethral injuries, there was no statistical difference in deep infection related to fixation (AP: 23.1%, IS: 0%, NAIF: 7.4%, P = 0.21). There was a higher rate of suprapubic catheter (SPC) use in urethral injuries compared with extraperitoneal injuries (57.9% vs. 4.9%, P < 0.0001). In the urethral injury group, SPC use did not have a statistically significant difference in infection rate (SPC: 18.2% vs. No SPC: 8.3%, P = 0.45). Early removal of the SPC before or during the definitive orthopaedic intervention did not significantly affect infection rate (early: 0% vs. delayed: 25.0%, P = 0.16).CONCLUSIONS:Surgeons should approach operative pelvic fractures with associated urologic injuries with caution given the high risk of infection. Further work must be done to elucidate the effect of anterior implants and SPC use and duration.LEVEL OF EVIDENCE:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

KW - anterior pelvis plate fixation

KW - bladder injury

KW - pelvic fracture

KW - urethral injury

UR - http://www.scopus.com/inward/record.url?scp=85185712376&partnerID=8YFLogxK

U2 - 10.1097/BOT.0000000000002745

DO - 10.1097/BOT.0000000000002745

M3 - Article

C2 - 38117571

AN - SCOPUS:85185712376

SN - 0890-5339

VL - 38

SP - 129

EP - 133

JO - Journal of orthopaedic trauma

JF - Journal of orthopaedic trauma

IS - 3

ER -

the EMIT Pelvic Fracture Study Group. Does Anterior Plating of Pelvic Ring Fractures Increase Infection Risk in Patients With Bladder or Urethral Injuries? Journal of orthopaedic trauma. 2024 Mar 1;38(3):129-133. doi: 10.1097/BOT.0000000000002745