The management of complex acetabular fractures in the elderly with fracture fixation and primary total hip replacement
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Abstract
Osteoporosis and associated fragility fractures are an increasing problem across the developed world. The elderly osteoporotic acetabular fracture presents a difficult problem due to high failure rates and poor outcomes. Standard management may or may not include fracture fixation, but generally includes a period of protected weight bearing, even if total hip replacement has been performed. We present a series of 12 cases of complex osteoporotic acetabular fractures in elderly patients, managed successfully using primary fracture fixation and total hip replacement with trabecular metal technology. Immediate weight bearing was allowed in all cases, few complications have been seen, and no component migration has been identified in any case.
Keywords
Acetabulum Arthroplasty Geriatric trauma Hip Pelvic traumaNotes
Conflict of interest
None.
References
- 1.Beaule PE, Griffin D, Matta J. The levine anterior approach for total hip replacement as the treatment for an acute acetabular fracture. J Orthop Trauma. 2004;18:623–9.PubMedCrossRefGoogle Scholar
- 2.Briffa N, Pearce R, Hill AM, Bircher M. Outcomes of acetabular fracture fixation with ten years’ follow-up. J Bone Joint Surg. 2011;93:229–36.CrossRefGoogle Scholar
- 3.Cole J, Dean MD, Bolhofner BR. Acetabular fracture fixation via a modified stoppa limited intrapelvic approach description of operative technique and preliminary treatment results. Clin Orthop Rel Res. 1994;305:112–23.Google Scholar
- 4.Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM, Melton LJ, Cummings SR, Kanis JA, IOF CSA Working Group on Fracture Epidemiology. Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporosis Int. 2011;22(5):1277–88.CrossRefGoogle Scholar
- 5.Helfet DL, Borelli J, DiPasquale T, Sanders R. Stabilisation of acetabular fractures in elderly patients. J Bone Joint Surg. 1992;74:753–65.PubMedGoogle Scholar
- 6.Joly JM, Mears DC. The role of total hip arthroplasty in acetabular fracture management. Oper Tech Orthop. 1993;3:80–102.CrossRefGoogle Scholar
- 7.Letournel E. The treatment of acetabular fractures through the ilioinguinal approach. Clin Orthop Rel Res. 1993;292:62–76.Google Scholar
- 8.Letournel E, Judet R. Fractures of the acetabulum. 2nd edn. Berlin: Springer; 1993.Google Scholar
- 9.Liebergall M, Mosheiff R, Low J, Goldvirt M, Matan Y, Segal D. Acetabular fractures: clinical outcome of surgical treatment. Clin Orthop Rel Res. 1999;336:205–16.Google Scholar
- 10.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. 1996;78:1632–45.PubMedGoogle Scholar
- 11.Mayo KA. Open reduction and internal fixation of fractures of the acetabulum. Results of 163 fractures. Clin Orthop Relat Res. 1994;305:31–7.PubMedGoogle Scholar
- 12.Mears DC. Surgical treatment of acetabular fractures in elderly patients with osteoporotic bone. J Am Acad Orthop Surg. 1999;7(2):128–41.PubMedGoogle Scholar
- 13.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.PubMedGoogle Scholar
- 14.Stoppa RE, Rives JL, Warlaumont CR, Verhaeghe PJ, Delattre JF. The use of Dacron in the repair of hernias of the groin. Surg Clin North Am. 1984;64(2):269–85.Google Scholar