Management of acetabular fractures in the geriatric patient

Marc Hanschen, Sebastian Pesch, Stefan Huber-Wagner, Peter Biberthaler

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

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.

Original languageEnglish
Article number37
JournalSICOT-J
Volume3
DOIs
StatePublished - 2017
Externally publishedYes

Keywords

  • Acetabular fracture
  • Elderly patient
  • Individualized treatment
  • Injury risk factors
  • Patient risk factors
  • Primary total hip replacement

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