PurposeAcetabular fractures are mainly caused by high energy trauma. Surgical fixation of these fractures requires extensive surgical exposure which increases the length of operation and blood loss as well. This may increase the risk of surgical site infection. Our aim is to evaluate the prevalence of surgical site infections and the risk factors associated with it so as to minimize its chances.Materials and MethodsA total of 261 patients who underwent acetabular fracture surgery were retrospectively reviewed. Patients were divided into 2 groups, with or without surgical site infection. Factors examined include patients' gender, age, body mass index (BMI), time between injury and surgery, operative time, estimated blood loss, number of packed red blood cell transfused, length of total intensive care unit (ICU) stay, fracture type, surgical approach, smoking status, patients' comorbids and associated injuries.ResultsFourteen patients (5.4%) developed surgical site infection. Out of 14 infections, 4 were superficial and 10 were deep. The factors that were found to be associated with surgical site infection following acetabular fracture fixation were prolonged operation time, increased BMI, prolonged ICU stay, larger amount of packed red blood cell transfused and associated genitourinary and abdominal trauma.ConclusionIn our study, we conclude that measures should be undertaken to attenuate the chances of surgical site infection in this major surgery by considering the risk factors significantly associated with it.

Primary total hip replacement is a valid and reasonable one stage surgical treatment of complex acetabular fractures and in aged individuals. However, the complications are not uncommon.

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Objective: To assess the utility and validation of the Surgical Apgar Score (SAS) in predicting postoperative complications of hip fractures. Methods: This prospective observational study included patients who received operations for hip fractures from 1st March 2017 to 30th June 2018 at the Department of Orthopedic Surgery, Liaquat National Hospital and Medical College. Patients were followed at the outpatient department, and complications and mortality were recorded through phone calls. The predictability of SAS for postoperative complications was assessed. Results: SAS≤4 was found as a significant predictor for postoperative pulmonary (P=0.008) and cardiac complications (P=0.042) as well as blood transfusion required to optimize postoperative hemoglobin (P=0.03) in the patients with hip fractures. Conclusions: SAS provides reliable feedback information about patients' postoperative risk during the surgery. Hip fracture patients with scores≤4 should be monitored for major complications both during the hospital admission and after the discharge.

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