Objective: the aim of this study was to document the occurrence of THA after acetabulum surgery and examine the factors that predict its occurrence. Methods: This study included 77 consecutive patients who were admitted for acetabulum fracture surgery between 2012 and 2019. The inclusion criteria were acetabular fractures and indications for operative management. The exclusion criteria were acetabular fractures treated non-operatively, fractures requiring primary THA, and periprosthetic acetabular fractures. Data concerning demographics, date of injury, date of surgery, surgical approach, stabilization, and further reconstructive surgery were collected retrospectively. The number of patients who underwent THA and their risk factors were recorded. The minimum follow-up for each patient was 2 years of observation. A total of 77 patients with a mean age of 53 years were included. Results: At a mean follow-up of 2 years, THA was performed in 16 (20.8%) patients due to post-traumatic arthritis. An analysis of the surgical approaches showed that the Kocher–Langenbeck approach increased the risk of THA nearly 12 times compared with the ilioinguinal approach (p = 0.016). Furthermore, the duration of the waiting period for surgery significantly impacted the occurrence of THA, with each additional day leading to an 89% increase in the risk of prosthesis usage (p = 0.001). Conclusions: This study suggests that acetabular fractures may lead to post-traumatic hip osteoarthritis. The surgical approach and the waiting time for surgery are potential factors that may predict secondary hip osteoarthritis and the need for subsequent THA. However, further investigations should be performed to establish predictors for secondary hip osteoarthritis, and especially to determine the impact of the surgical approach.

Background and Objectives: The objective of this retrospective study was to investigate the association between acetabulum fractures; the mechanism of injury; and variables such as BMI, duration of hospital stay, blood loss, and surgery time. By exploring these factors, we aim to enhance our understanding of them and their impact on the healing process and the subsequent management of pelvic fractures. Materials and Methods: This study included 67 of 136 consecutive patients who were admitted for pelvic ring fracture surgery between 2017 and 2022. The data were collected prospectively at a single trauma center. The inclusion criteria were acetabulum fractures and indications for operative treatment. The exclusion criteria were non-operative treatment for acetabular and pelvic ring fractures, fractures requiring primary total hip arthroplasty (THA), and periprosthetic acetabular fractures. Upon admission, all patients underwent evaluation using X-ray and computed tomography (CT) scans of the pelvis. Results: The present study found no statistically significant differences between the examined groups of patients with pelvic fractures in terms of BMI, surgery duration, length of hospital stay, and blood transfusion. However, two notable findings approached statistical significance. Firstly, patients who experienced a fall from height while sustaining a pelvic fracture required a higher number of blood transfusions (2.3 units) than those with other mechanisms of injury which was close to achieving statistical significance (p = 0.07). Secondly, patients undergoing posterior wall stabilization required a significantly lower number of blood transfusions than those with other specific pelvic injuries (0.33 units per patient), approaching statistical significance (p = 0.056). Conclusions: The findings indicated that factors such as BMI, time of surgery, blood loss, and the duration of hospital stay were not directly correlated with the morphology of acetabular fractures, the presence of additional trauma, or the mechanism of injury. However, in the studied group, the patients whose mechanism of trauma involved falling from height had an increased number of blood transfusions compared to other groups. Moreover, the patients who had surgery due to posterior wall acetabulum fracture had decreased blood transfusions compared to those with other Judet and Letournel types of fractures. Additionally, they had the shortest duration of surgery.

Objective: The objective of this study was to investigate the association between BMI, days spent in hospital, blood loss, and surgery time in patients who suffered from isolated pelvic fractures and pelvic fractures with concomitant injuries (polytrauma patients). Methods: This study included 76 consecutive patients who were admitted for pelvic ring fracture surgery between 2017 and 2022. The inclusion criteria were pelvic fractures and indications for operative treatment (LC II and III, APC II and III, and VS). The exclusion criteria were non-operative treatment for pelvic ring fractures, acetabular fractures and fractures requiring primary total hip arthroplasty (THA), and periprosthetic acetabular fractures. Demographic data were collected, including age (in years), sex, type of fracture according to Young–Burgess, date of injury and surgery, surgical approach and stabilization methods, mechanism of trauma, concomitant trauma in other regions, body mass index (BMI), blood transfusions, number of days spent in the hospital, and surgery duration. Results: Patients who suffered from a pelvic ring injury with concomitant injuries had a significantly greater amount of blood units transferred (1.02 units vs. 0.55 units), and the length of hospital stay was also longer compared to the mean results (5.84 days vs. 3.58 days), p = 0.01 and p = 0.001, respectively. Moreover, patients with a higher BMI had more frequent APC II and APC III fractures (p = 0.012). Conclusions: This study demonstrates that polytrauma patients who suffered from pelvic ring injury are, indeed, at risk of blood transfusion in terms of greater units of blood and a longer duration of hospital stay. Moreover, BMI has an impact on pelvic ring fracture morphology. However, there is no doubt that there is an absolute need for further studies and investigations to provide better overall management of polytrauma patients with pelvic fractures.

The aim of this study was to investigate the impact of the COVID-19 pandemic on pelvic trauma surgery in Poland. This study comprises 132 consecutive patients admitted for pelvic fracture surgery from 2019 to 2022, separating them into 2 groups; pre-COVID (1 year before the outbreak of pandemic − 2019) and COVID period (in Poland 2020–2022). The data was collected respectively in a single trauma center. Demographic data was collected, additionally, the type of fracture according to Young-Burgess and Letournel-Judet classification system, date of the injury and surgery, the surgical approach and stabilization methods, mechanism of trauma, concomitant injuries, body mass index (BMI), blood transfusions, number of days spent in the hospital, and surgery duration. Patients during the pandemic had statistically significantly shorter duration of hospital stay, and lesser amount of blood units transfused comparing to the non- pandemic group, 4.50 days vs. 6.90 days (p < 0.001) and 1.20 units vs. 1.40 units (p = 0.0401) respectively. Patients with acetabulum fractures required more blood transfusion units (p < 0.0001), comparing to those with pelvic ring injuries. Moreover, the acetabulum fractures were more time demanding comparing to pelvic ring injury (151 min vs. 128 min, respectively) (p < 0.0001) as well as length of hospital stay was longer (5.18 days, 3.85 days (respectively) (p = 0.042). During the COVID-19 period, comparing patients with acetabulum fractures to those with pelvic ring injuries, they required more blood transfusion units, the acetabulum fractures were more time demanding with increased days of hospitalization. Additionally, patients during the COVID-19 period remained hospitalized for a shorter period of time and received lesser amount of blood transfusions with pelvic ring injuries.

Background: Pelvic ring fractures are a significant and growing health problem in the field of trauma and orthopedic surgery. The aim of this paper was to present a concise description of these musculoskeletal injuries, available classification systems, and vascular and genitourinary complications. Results: The most common complications of serious pelvic ring fractures are arterial and venous hemorrhages, as well as urethral injuries. Arterial hemorrhages most often originate from the trunk or branches of the iliac artery, and the standard treatment is pelvic stabilization and implementation of intravascular procedures. In the case of venous hemorrhages, peritoneal pelvic packing is the most important. Conclusions: A multi-disciplinary approach and treatment algorithmization are important to facilitate the prioritization of therapeutic procedures. Treatment of patients with pelvic ring fractures should take place in specialized trauma centers.

Objective: To evaluate patient-assessed quality of life (QoL) following operative treatment of acetabular fractures and pelvic ring injuries and identify differences in their assessment of QoL depending on sex and age group. Methods: The study included 75 patients, 41 who had suffered acetabular fractures and 34 pelvic ring fractures, who had been treated operatively over a 6-year period (2017–2022). Post-operative HRQOL scores were evaluated using the World Health Organization Quality of Life BREF scale (WHQOL-BREF) and RAND Short Form 36 (SF-36). Separate analyses were completed for men and women, and we compared the data between five age groups. Results: The male patients scored slightly higher in all domains than the women in the acetabular fracture group. In the ring fracture group women reported higher scores in the psychological (72.67 vs. 69.44) and social domains (81.67 vs. 77.08). The men (80%) reported more significant overall satisfaction with their health in the acetabular group compared with the women (p = 0.0306). In the SF36 analysis, for both acetabular and ring fracture groups the lowest average QoL was recorded in the physical health composite summary (PHC) with a score of 41.34 ± 9.49 and 41.21 ± 9.19, respectively. Men scored higher for all eight scales in the ring fracture and all except general health in the acetabular fracture group (p = 0.0166). For the mental health composite (MHC), men had a better mean score in both fracture groups with significant differences for between both genders for the acetabular group (p = 0.0352). For age group analysis of the SF36, in the acetabular group, the youngest age group (70 years) (p = 0.0306 and p = 0.0069, respectively), similarly to the PHC (p = 0.0279). Additionally, for the overall mental health summary of the acetabular group for the five age groups, there were significant differences between the youngest age group and the oldest age group (p = 0.0372). In contrast, for the ring fracture group, the oldest age group (>70 years) scored the worst in all four scales of the physical health composite and the 70 years and the highest in the 61–70 years age group, with a statistical significance (p = 0.0367). Conclusions: Patients that sustain a pelvic fracture and are treated operatively are at a higher risk of deterioration in quality of life. Using both functional assessments, male patients emphasized improved quality in more spheres that was evaluated than women.