Complications of pelvic ring fixation in patients requiring laparotomy

Abstract Background Pelvic ring disruptions in blunt trauma are rarely an isolated finding. Many individuals needing operative pelvic fixation also require laparotomy for other injuries. Pelvic fixation can be performed by open reduction and internal fixation (ORIF) or external fixation (Ex-fix). Of...

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Bibliographic Details
Published in:The Journal of surgical research 2015-11, Vol.199 (1), p.244-248
Main Authors: Miskimins, Richard, MD, Decker, Michael, MD, Hobby, Bryon, MD, Howdieshell, Thomas, MD, Lu, Stephen, MD, West, Sonlee D., MD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Child
External fixation
Female
Fracture Fixation, Internal - methods
Fractures, Bone - surgery
Hernia, Ventral - epidemiology
Hernia, Ventral - etiology
Humans
Internal fixation
Laparotomy
Male
Middle Aged
Multiple Trauma - surgery
Pelvic Bones - injuries
Pelvic Bones - surgery
Pelvic fracture
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Retrospective Studies
Surgery
Surgical Wound Infection - epidemiology
Surgical Wound Infection - etiology
Treatment Outcome
Young Adult
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Summary:Abstract Background Pelvic ring disruptions in blunt trauma are rarely an isolated finding. Many individuals needing operative pelvic fixation also require laparotomy for other injuries. Pelvic fixation can be performed by open reduction and internal fixation (ORIF) or external fixation (Ex-fix). Often when a laparotomy incision is present, ORIF is performed by extending this incision. We hypothesized ORIF performed by extending the laparotomy incision would result in higher rates of ventral hernia and wound complications versus Ex-fix. Methods All patients admitted from 2004–June 2014 who underwent laparotomy and pelvic fixation either by ORIF through extension of a laparotomy incision (ORIF group) or definitive Ex-fix group were identified. Injury severity score, demographics, associated injuries, and complications were collected. Results A total of 35 patients were identified who underwent laparotomy and pelvic fixation, 21 underwent Ex-fix, whereas 14 underwent ORIF through an extended laparotomy incision. There were no differences in injury severity score, demographics, associated injuries, or rate of ventral hernia. The ORIF group had more laparotomy incision infections (50.0% versus 4.8%, P  
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2015.05.051