Pelvic and acetabular fracture management in intravenous drug users

Introduction Pelvic and acetabular fractures are significant injuries associated with high morbidity or mortality. Intravenous drug users (IVDU) represent a challenging group of patients, with an increased risk of complications and infection. To our knowledge there has not been any published literature concerning IVDU and this type of injuries. Patients and methods A group of 19 patients with a history of IVDU and who had sustained an injury were identified. Results The mean age at injury was 36 years old; nine had a pelvic fracture and ten had an acetabular fracture. No complications were observed in the pelvic group. In the acetabular group, the infection risk was 50% and the risk of femoral head avascular necrosis was 33%. The mean follow up was 43.1 months from injury. Conclusion We advise emphasis in the high infection and avascular necrosis rates, when consenting the patient for an operation. Furthermore, non-operative treatment should be considered, where possible. Level of evidence Level III. Retrospective cohort study. Prognostic-investigating the effect of a patient characteristic on the outcome of the disease.