{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:23:43Z","timestamp":1789586623551,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The aim of this study was to determine whether the retention of pelvic ring fixation metalware in women of childbearing age following traumatic fractures is associated with increased rates of caesarean section at subsequent childbirth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Database searches were conducted across MEDLINE, Embase, CENTRAL and Scopus, spanning 1946\u20132025. Eligible studies included women of childbearing age with prior traumatic pelvic ring fractures, managed either operatively or non\u2010operatively and compared outcomes between those with and without retained fixation metalware at the time of childbirth. The outcome of interest was the incidence of subsequent caesarean section delivery. Fixed effect meta\u2010analysis using the Mantel\u2013Haenszel method was undertaken, with the resultant pooled odds ratio (OR) presented as a forest plot.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three studies were included for review, a total of 118 births (51 caesarean section and 67 vaginal) eligible for meta\u2010analysis. Retention of pelvic ring metalware at the time of subsequent childbirth was associated with an increased likelihood of caesarean section (OR 2.39, 95% CI 1.03\u20135.56;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) compared to women giving birth without retained metalware.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Retention of pelvic fixation metalware following pelvic ring fracture may be associated with a higher likelihood of caesarean section among women of childbearing age compared with those without metalware in\u00a0situ at the time of subsequent childbirth. Further research is warranted to inform counselling and shared decision\u2010making regarding removal of pelvic fixation metalware in this population, given the absence of consensus recommendations from any orthopaedic or obstetric advisory bodies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70489","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T12:43:11Z","timestamp":1768394591000},"page":"1086-1093","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Pelvic Ring Fixation Metalware Retention and Birth Modality in Women of Childbearing Age: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8555-6387","authenticated-orcid":false,"given":"Zac","family":"Tsigaras","sequence":"first","affiliation":[{"name":"Department of Orthopaedics The Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6043-0710","authenticated-orcid":false,"given":"Nathan","family":"Kirzner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Sleaby","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Kimmel","sequence":"additional","affiliation":[{"name":"Allied Health Executive The Alfred Hospital  Melbourne Victoria Australia"},{"name":"School of Public Health and Preventative Medicine Monash University  Melbourne Victoria Australia"},{"name":"National Trauma Research Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry","family":"Stephens","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The Alfred Hospital  Melbourne Victoria Australia"},{"name":"Department of Orthopaedics Peninsula Health  Frankston Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The Alfred Hospital  Melbourne Victoria Australia"},{"name":"School of Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1750458920947358"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2010.10.001"},{"issue":"2","key":"e_1_2_7_4_1","article-title":"Pelvic Ring Fracture Management and Subsequent Pregnancy: A Summary of Current Literature","volume":"8","author":"Lewis A. 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