Volume 3, 2017
Special Issue: "Proximal Femoral Fractures" Guest Editor: J. Waddell
|Number of page(s)||8|
|Section||Pelvis & Acetabulum|
|Published online||25 May 2017|
Management of acetabular fractures in the geriatric patient
Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Strasse 22, 81675
* Corresponding author: email@example.com
Accepted: 5 April 2017
Introduction: Open reduction and internal fixation (ORIF) is standard care for most acetabular fractures. With increasing numbers of acetabular fractures in the elderly, the risk of revision surgery and conversion to total hip replacement (THR) is increasing. Alarmingly, about 20–25% of acetabular fractures in the elderly following ORIF needed revision and conversion to delayed THR.
Methods: Recently, prognostic factors have been identified, which correlate with an increased risk of worse outcomes following ORIF of acetabular fractures in the elderly patient. Patient risk factors include, for example, age, comorbidities, and degree of osteoporosis. Injury risk factors mainly include the fracture pattern.
Results: The concept of primary THR following acetabular fractures is an alternative to ORIF, especially in the elderly patient. Satisfactory outcomes have been reported in different studies for primary THR following acetabular fractures in the elderly. The surgeon should be aware of strict selection criteria in order to achieve these satisfactory outcomes. Therefore, an individualized treatment plan has to be defined for elderly patients following acetabular fractures.
Discussion: Here, the advantages and disadvantages of ORIF versus THR following acetabular fractures in the elderly are discussed.
Key words: Acetabular fracture / Elderly patient / Primary total hip replacement / Individualized treatment / Patient risk factors / Injury risk factors
© The Authors, published by EDP Sciences, 2017
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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