Does Pelvic Embolization Increase Infection Rates in Patients Who Undergo Open Treatment of Acetabular Fractures?

Objective: Evaluate the impact of pelvic embolization on postoperative infection rate after acetabular fracture fixation.

Design: Retrospective study of 3 separate cohorts. Setting: Level I Trauma Center. Patients/participants: Identified patients who underwent angiography of the pelvis as well as required an open reduction internal fixation (ORIF) of an acetabular fracture. This group was compared to a control group of patients with an acetabular fracture, which did not undergo angiography, and underwent ORIF. Intervention: ORIF of an aectabular fracture with angiography ± embolization. Main outcome measurements: Deep infection rate.

Results: Seventy-two patients remained for final analysis; 25 patients underwent embolization, 16 patients underwent angiography without embolization, and 31 patients did not undergo angiography. Two out of 25 (8%) patients developed infections in the embolization group, one deep infection and one superficial infection. Five out of 16 (31%) patients developed deep infections in the nonembolization group. Control group of patients who did not undergo angiography had a deep infection rate of 9.6%.

Conclusion: Despite previous reports of high infection rates after pelvic embolization, the deep infection rate was only 4% after embolization in our cohort. This suggests that concerns for higher rates of infection are not substantiated, and pelvic embolization should be performed when indicated. Level of evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.