Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr;49(2):709-722.
doi: 10.1007/s00068-022-02118-3. Epub 2022 Nov 25.

The relation between surgical approaches for pelvic ring and acetabular fractures and postoperative complications: a systematic review

Robert A Timmer  1 , Cassidy Q B Mostert  2 , Pieta Krijnen  2 , Sven A G Meylaerts  3 , Inger B Schipper  2
Affiliations

The relation between surgical approaches for pelvic ring and acetabular fractures and postoperative complications: a systematic review

Robert A Timmer et al. Eur J Trauma Emerg Surg. 2023 Apr.

Abstract

Introduction: Although many articles report complications after pelvic ring and acetabular fracture surgery, a general overview of complication rates and potential risk factors is lacking. The current review provides a comprehensive summary of the complications after pelvic ring and acetabular fracture surgery in relation to the surgical approach.

Material and methods: Pubmed and Embase databases were systematically searched using the key words: pelvic fracture, acetabular fracture, fixation, surgical approaches, complications, and their synonyms. Extracted data included patient and fracture characteristics, surgical approaches, and post-operative complications; surgical site infections (SSI), implant-related complications, malunion and non-union. Study data were summarized using descriptive statistics.

Results: Twenty-two studies (twenty-one retrospective cohort studies, of which three comparative, and one randomized controlled trial) were included in this review. The overall complication rates reported for the included surgical approaches were: 17% for the (Modified) Stoppa approach, 11% for percutaneous fixation, 5% for the Kocher-Langenbeck approach, 7% for the ilioinguinal approach and 31% for external fixation. The most frequent complications were SSI (22%) and neurological (31%) complications, which were most often reported in patients treated with an external fixator. Re-operation rates were comparable for the surgical approaches (4-8%). Two studies reported on risk factors and identified concomitant traumatic injuries, prolonged ICU stay and high body mass index as risk factors for SSI.

Conclusion: External fixation of pelvic fractures is associated with highest complications rates including SSI's and neurological complications. Although post-operative complications are frequently reported after pelvic fracture surgery, more studies are needed that identify potential risk factors. These will assist the surgeon in (pre)operative decision making and development of preventive strategies.

Keywords: Acetabular fractures; Pelvic ring fractures; Post-operative complications; Risk factors; Surgical approaches.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flowchart of article selection
See this image and copyright information in PMC

References

    1. Giannoudis PV, Grotz MR, Tzioupis C, Dinopoulos H, Wells GE, Bouamra O, et al. Prevalence of pelvic fractures, associated injuries, and mortality: the United Kingdom perspective. J Trauma. 2007;63(4):875–883. - PubMed
    1. Schmal H, Markmiller M, Mehlhorn AT, Sudkamp NP. Epidemiology and outcome of complex pelvic injury. Acta Orthop Belg. 2005;71(1):41–47. - PubMed
    1. Buller LT, Best MJ, Quinnan SM. A nationwide analysis of pelvic ring fractures: incidence and trends in treatment, length of stay, and mortality. Geriatr Orthop Surg Rehabil. 2016;7(1):9–17. - PMC - PubMed
    1. Pereira GJC, Damasceno ER, Dinhane DI, Bueno FM, Leite JBR, Ancheschi BDC. Epidemiology of pelvic ring fractures and injuries. Rev Bras Ortop. 2017;52(3):260–269. - PMC - PubMed
    1. Vaidya R, Scott AN, Tonnos F, Hudson I, Martin AJ, Sethi A. Patients with pelvic fractures from blunt trauma. What is the cause of mortality and when? Am J Surg. 2016;211(3):495–500. - PubMed

Publication types