Abstract
Four treatments for geriatric acetabular fractures have been described in the literature to date: nonoperative, percutaneous fixation, open reduction and internal fixation (ORIF), and acute arthroplasty. Data on nonoperative treatment and percutaneous fixation are limited. There are more studies on ORIF and a fair number of small studies on acute arthroplasty. These studies do provide some guidance to clinicians and an excellent starting point for further work. However, the current literature is flawed by small sample size, retrospective methodology, and obvious selection bias that render comparison between techniques impossible. Future work is needed to address this obvious knowledge gap as clinicians currently have significant decisional uncertainty regarding the ideal treatment for any individual patient.
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References
Anglen JO, Burd TA, Hendricks KJ, Harrison P. The “Gull sign”. A harbinger of failure for internal fixation of geriatric acetabular fractures. J Orthop Trauma. 2003;17(9):625–34.
Béaule PE, Le Duff MJ, Dorey FJ, Amstutz HC. Fate of cementless acetabular components retained during revision total hip arthroplasty. J Bone Joint Surg Am. 2003;85-A(12):2288–93.
Bellabarba C, Berger RA, Bentley CD, Quigley LR, et al. Cementless acetabular reconstruction after acetabular fracture. J Bone Joint Surg Am. 2001;83-A(6):868–76.
Boardman KP, Charnley J. Low-friction arthroplasty after fracture-dislocations of the hip. J Bone Joint Surg Br. 1978;60-B(4):495–7.
Boraiah S, Ragsdale MS, Achor T, Zelicof S, Asprinio DE. Open reduction internal fixation and primary total hip arthroplasty of selected acetabular fractures. J Orthop Trauma. 2009;23(4):243–8.
Carroll EA, Huber FG, Goldman AT, Virkus WW, Pagenkopf E, Lorich DG, Helfet DL. Treatment of acetabular fractures in an older population. J Orthop Trauma. 2010;24(10):637–44.
Chakravarty R, Toossi N, Katsman A, Cerynik DL, Harding SP, Johanson NA. Percutaneous column fixation and total hip arthroplasty for the treatment of acute acetabular fracture in the elderly. J Arthroplast. 2014;29(4):817–21.
Enocson A, Blomfeldt R. Acetabular fractures in the elderly treated with a primary Burch-Schneider reinforcement ring, autologous bone graft, and a total hip arthroplasty: a prospective study with a 4-year follow-up. J Orthop Trauma. 2014;28(6):330–7.
Gary JL, Lefaivre KA, Gerold F, Hay MT, Reinert CM, Starr AJ. Survivorship of the native hip joint after percutaneous repair of the acetabular fractures in the elderly. Injury. 2011;42(10):1144–51.
Gary JL, VanHal M, Gibbons SD, Reinert CM, Starr AJ. Functional outcomes in elderly patients with acetabular fractures treated with minimally invasive reduction and percutaneous fixation. J Orthop Trauma. 2012;26(5):278–83.
Gary JL, Paryavi E, Gibbons SD, Weaver MJ, et al. Effect of surgical treatment on mortality after acetabular fracture in the elderly: a multicenter study of 454 patients. J Orthop Trauma. 2015;29(4):202–8.
Helfet DL, Borrelli JJ, DiPasquale T, Sanders R. Stabilization of acetabular fractures in elderly patients. J Bone Joint Surg Am. 1992;74(5):753–65.
Herscovici D Jr, Lindvall E, Bolhofner B, Scaduto JM. The combined hip procedure: open reduction internal fixation combined with total hip arthroplasty for the management of acetabular fractures in the elderly. J Orthop Trauma. 2010;24(5):291–6.
Jeffcoat DM, Carroll EA, Huber FG, Goldman AT, Miller AN, Lorich DG, Helfet DL. Operative treatment of acetabular fractures in an older population through a limited ilioinguinal approach. J Orthop Trauma. 2012;26(5):284–9.
Johnson KA. Cementless total hip replacement complications. Vet Comp Orthop Traumatol. 2015;28(1):V–V1.
Kim JW, Herbert B, Hao J, Min W, et al. Acetabular fractures in elderly patients: a comparative study of low-energy versus high-energy injuries. Int Orthop. 2015;39(6):1175–6.
Letournel E. The treatment of acetabular fractures through the ilioinguinal approach. Clin Orthop Relat Res. 1993;292:62–76.
Lin C, Caron J, Schmidt AH, Torchia M, Templeman D. Functional outcomes after total hip arthroplasty for the acute management of acetabular fractures: 1-to 14-year follow-up. J Orthop Trauma. 2015;29(3):151–9.
Makridis KG, Obakponovwe O, Bobak P, Giannoudis PV. Total hip arthroplasty after acetabular fracture: incidence of complications, reoperation rates and functional outcomes: evidence today. J Arthroplast. 2014 Oct;29(10):1983–90.
Malhotra R, Singh DP, Jain V, Kumar V, Singh R. Acute total hip arthroplasty in acetabular fractures in the elderly using the Octopus system: mid term to long term follow-up. J Arthroplasty. 2013;28(6):1005–9.
Manson TT, Reider L, O’Toole RV, Scharfstein DO, et al. Variation in treatment of displaced geriatric acetabular fractures among 15 level-1 trauma centers. J Orthop Trauma. 2016;30(9):457–62.
Matta JM. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am. 1996;78(11):1632–45.
Mears DC, Shirahama M. Stabilization of an acetabular fracture with cables for acute total hip arthroplasty. J Arthroplast. 1998;13(1):104–7.
Mears DC, Velyvis JH. Acute total hip arthroplasty for selected displaced acetabular fractures: two to twelve-year results. J Bone Joint Surg Am. 2002;84-A:1):1–9.
Mouhsine E, Garofalo R, Borens O, Blanc CH, Wettstein M, Leyvraz PF. Cable fixation and early total hip arthroplasty in the treatment of acetabular fractures in elderly patients. J Arthroplast. 2004;19(3):344–8.
O’Toole RV, Hui E, Chandra A, Nascone JW. How often does open reduction and internal fixation of geriatric acetabular fractures lead to hip arthroplasty? J Orthop Trauma. 2014;28(3):148–53.
Pritchett JW, Bortel DT. Total hip replacement after central fracture dislocation of the acetabulum. Orthop Rev. 1991;20(7):607–10.
Rickman M, Young J, Trompeter A, Pearce R, Hamilton M. Managing acetabular fractures in the elderly with fixation and primary arthroplasty: aiming for early weightbearing. Clin Orthop Relat Res. 2014;472(11):3375–82.
Romness DW, Lewallen DG. Total hip arthroplasty after fracture of the acetabulum. Long-term results. J Bone Joint Surg Br. 1990;72(5):761–4.
Ryan SP, Manson TT, Sciadini MF, Nascone JW, et al. Functional outcomes of elderly patients with nonoperatively treated acetabular fractures that meet operative criteria. J Orthop Trauma. 2017;31(12):644–9.
Sermon A, Broos P, Vanderschot P. Total hip replacement for acetabular fractures. Results in 121 patients operated on between 1983 and 2003. Injury. 2008;39(8):914–21.
Spencer RF. Acetabular fractures in older patients. J Bone Joint Surg Br. 1989;71(5):774–6.
Starr AJ, Jones AL, Reinert CM, Borer DS. Preliminary results and complications following limited open reduction and percutaneous screw fixation of displaced fractures of the acetabulum. Injury. 2001;32(Suppl 1):SA45–50.
Starr AJ, Watson JT, Reinert CM, Jones AL, et al. Complications following the “T extensile” approach: a modified extensile approach for acetabular fracture surgery-report of forty-three patients. J Orthop Trauma. 2002;16(8):535–42.
Tidermark J, Blomfeldt R, Ponzer S, Söderqvist A, Tömkvist H. Primary total hip arthroplasty with a Burch-Schneider antiprotrusion cage and autologous bone grafting for acetabular fractures in elderly patients. J Orthop Trauma. 2003;17(3):193–7.
Weber M, Berry DJ, Harnsen WS. Total hip arthroplasty after operative treatment of an acetabular fracture. J Bone Joint Surg Am. 1998;80(9):1295–305.
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O’Toole, R.V. (2020). Outcomes of Treatment Options for Acetabular Fractures in Older Patients. In: Manson, T. (eds) Acetabular Fractures in Older Patients. Springer, Cham. https://doi.org/10.1007/978-3-030-25105-5_10
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DOI: https://doi.org/10.1007/978-3-030-25105-5_10
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