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Immediate full weight bearing after pelvic percutaneous fixation by screw for simple acetabular and pelvic ring fractures in patients older than sixty five years

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A Correction to this article was published on 14 July 2022

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Abstract

Purpose

The aim of this study was to assess the walking and weight-bearing abilities of patients older than 65 years with a simple acetabular or pelvic ring fracture treated with pelvic percutaneous screwing (PPS).

Methods

This study included 27 patients. This was a retrospective, single-centre observational study conducted in a level 1 trauma centre from September 2019 to April 2021. All patients older than 65 years who underwent PPS for an acetabular or pelvic ring fracture were included.

Results

All patients were able to walk and bear weight at one day after PPS. The mean walking distance increased from 19.4 m the day after the operation to 59.8 m, 497.8 m, and 1402 m at discharge, three and six weeks after the operation, respectively. The average pain visual analog scale scores before and after the operation were 4.1 (range, 3.6–5.1; standard deviation [SD], 0.63) and 0.9 (range, 0.5–1.2; SD, 0.25), respectively (p < .0001). The average daily dose of paracetamol used before and after the operation was 2.2 (range, 1.7–3.1; SD, 0.59) g/d and 1.3 (range, 0.6–1.7; SD, 0.40) g/d, respectively (p = .0232). The average daily dose of morphine used before and after the operation was 5.7 (range, 4.7–6.7; SD, 0.76) mg/d and 1.6 (range, 0.5–2.9; SD, 1.09) mg/d, respectively (p = .0001).

Conclusion

All included patients were able to walk at one day after PPS. PPS was associated with reduced pain as well as a reduction in paracetamol and morphine use.

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Data availability

All the data are available.

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References

  1. Ferguson TA, Patel R, Bhandari M, Matta JM (2010) Fractures of the acetabulum in patients aged 60 years and older: an epidemiological and radiological study. J Bone Joint Surg Br 92:250–257. https://doi.org/10.1302/0301-620X.92B2.22488

    Article  CAS  PubMed  Google Scholar 

  2. Butterwick D, Papp S, Gofton W et al (2015) Acetabular fractures in the elderly: evaluation and management. J Bone Joint Surg Am 97:758–768. https://doi.org/10.2106/JBJS.N.01037

    Article  PubMed  Google Scholar 

  3. Judet R, Judet J, Lanzetta A, Letournel E (1968) Fractures of the acetabulum. Classification and guiding rules for open reduction. Arch Ortop 81:119–158

    CAS  PubMed  Google Scholar 

  4. Letournel E, Judet R (1993) Fractures of the acetabulum, 2nd edn. Springer-Verlag, Berlin Heidelberg

    Book  Google Scholar 

  5. Briffa N, Pearce R, Hill AM, Bircher M (2011) Outcomes of acetabular fracture fixation with ten years’ follow-up. J Bone Joint Surg Br 93:229–236. https://doi.org/10.1302/0301-620X.93B2.24056

    Article  CAS  PubMed  Google Scholar 

  6. Giannoudis PV, Kanakaris NK, Dimitriou R et al (2011) The surgical treatment of anterior column and anterior wall acetabular fractures: short- to medium-term outcome. J Bone Joint Surg Br 93:970–974. https://doi.org/10.1302/0301-620X.93B7.26105

    Article  CAS  PubMed  Google Scholar 

  7. Giannoudis PV, Grotz MRW, Papakostidis C, Dinopoulos H (2005) Operative treatment of displaced fractures of the acetabulum. A meta-analysis. J Bone Joint Surg Br 87:2–9

    Article  CAS  Google Scholar 

  8. Tannast M, Najibi S, Matta JM (2012) Two to twenty-year survivorship of the hip in 810 patients with operatively treated acetabular fractures. J Bone Joint Surg Am 94:1559–1567. https://doi.org/10.2106/JBJS.K.00444

    Article  PubMed  Google Scholar 

  9. Dailey SK, Archdeacon MT (2014) Open reduction and internal fixation of acetabulum fractures: does timing of surgery affect blood loss and OR time? J Orthop Trauma 28:497–501. https://doi.org/10.1097/BOT.0000000000000153

    Article  PubMed  Google Scholar 

  10. Magnussen RA, Tressler MA, Obremskey WT, Kregor PJ (2007) Predicting blood loss in isolated pelvic and acetabular high-energy trauma. J Orthop Trauma 21:603–607. https://doi.org/10.1097/BOT.0b013e3181599c27

    Article  PubMed  Google Scholar 

  11. Firoozabadi R, Swenson A, Kleweno C, Routt MC (2015) Cell saver use in acetabular surgery: does approach matter? J Orthop Trauma 29:349–353. https://doi.org/10.1097/BOT.0000000000000292

    Article  PubMed  Google Scholar 

  12. Mears DC, Rubash HE, Sawaguchi T (1985) Fractures of the acetabulum. The Hip 95–113

  13. Vanderschot P (2007) Treatment options of pelvic and acetabular fractures in patients with osteoporotic bone. Injury 38:497–508. https://doi.org/10.1016/j.injury.2007.01.021

    Article  CAS  PubMed  Google Scholar 

  14. Antell NB, Switzer JA, Schmidt AH (2017) Management of acetabular fractures in the elderly. J Am Acad Orthop Surg 25:577–585. https://doi.org/10.5435/JAAOS-D-15-00510

    Article  PubMed  Google Scholar 

  15. Spencer RF (1989) Acetabular fractures in older patients. J Bone Joint Surg Br 71:774–776. https://doi.org/10.1302/0301-620X.71B5.2584245

    Article  CAS  PubMed  Google Scholar 

  16. Jain R, Basinski A, Kreder HJ (2003) Nonoperative treatment of hip fractures. Int Orthop 27:11–17. https://doi.org/10.1007/s00264-002-0404-y

    Article  PubMed  Google Scholar 

  17. Chatterton BD, Moores TS, Ahmad S et al (2015) Cause of death and factors associated with early in-hospital mortality after hip fracture. Bone Jt J 97B:246–251. https://doi.org/10.1302/0301-620X.97B2.35248

    Article  Google Scholar 

  18. Roche JJW, Wenn RT, Sahota O, Moran CG (2005) Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ 331:1374. https://doi.org/10.1136/bmj.38643.663843.55

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Brown CJ, Friedkin RJ, Inouye SK (2004) Prevalence and outcomes of low mobility in hospitalized older patients. J Am Geriatr Soc 52:1263–1270. https://doi.org/10.1111/j.1532-5415.2004.52354.x

    Article  PubMed  Google Scholar 

  20. Mouhsine E, Garofalo R, Borens O et al (2005) Percutaneous retrograde screwing for stabilisation of acetabular fractures. Injury 36:1330–1336. https://doi.org/10.1016/j.injury.2004.09.016

    Article  CAS  PubMed  Google Scholar 

  21. Gary JL, VanHal M, Gibbons SD et al (2012) Functional outcomes in elderly patients with acetabular fractures treated with minimally invasive reduction and percutaneous fixation. J Orthop Trauma 26:278–283. https://doi.org/10.1097/BOT.0b013e31823836d2

    Article  PubMed  Google Scholar 

  22. Elzohairy MM, Salama AM (2017) Open reduction internal fixation versus percutaneous iliosacral screw fixation for unstable posterior pelvic ring disruptions. Orthop Traumatol Surg Res OTSR 103:223–227. https://doi.org/10.1016/j.otsr.2016.12.002

    Article  CAS  PubMed  Google Scholar 

  23. Kim JJ, Kim JW, Oh HK (2014) The submuscular sliding plate technique for acetabular posterior wall fractures extending to the acetabular roof. Orthop Traumatol Surg Res OTSR 100:967–970. https://doi.org/10.1016/j.otsr.2014.09.020

    Article  CAS  PubMed  Google Scholar 

  24. Lin Y-C, Chen C-H, Huang H-T et al (2008) Percutaneous antegrade screwing for anterior column fracture of acetabulum with fluoroscopic-based computerized navigation. Arch Orthop Trauma Surg 128:223–226. https://doi.org/10.1007/s00402-007-0369-9

    Article  PubMed  Google Scholar 

  25. Caviglia H, Mejail A, Landro ME, Vatani N (2018) Percutaneous fixation of acetabular fractures. EFORT Open Rev 3:326–334. https://doi.org/10.1302/2058-5241.3.170054

    Article  PubMed  PubMed Central  Google Scholar 

  26. Meinberg EG, Agel J, Roberts CS et al (2018) Fracture and dislocation classification compendium-2018. J Orthop Trauma 32(Suppl 1):S1–S170. https://doi.org/10.1097/BOT.0000000000001063

    Article  PubMed  Google Scholar 

  27. Ochs BG, Marintschev I, Hoyer H et al (2010) Changes in the treatment of acetabular fractures over 15 years: Analysis of 1266 cases treated by the German Pelvic Multicentre Study Group (DAO/DGU). Injury 41:839–851. https://doi.org/10.1016/j.injury.2010.04.010

    Article  PubMed  Google Scholar 

  28. Rommens PM, Hofmann A (2013) Comprehensive classification of fragility fractures of the pelvic ring: recommendations for surgical treatment. Injury 44:1733–1744. https://doi.org/10.1016/j.injury.2013.06.023

    Article  PubMed  Google Scholar 

  29. Moed BR, McMichael JC (2007) Outcomes of posterior wall fractures of the acetabulum. J Bone Joint Surg Am 89:1170–1176. https://doi.org/10.2106/JBJS.F.00473

    Article  PubMed  Google Scholar 

  30. Liebergall M, Mosheiff R, Low J, et al (1999) Acetabular fractures. Clinical outcome of surgical treatment. Clin Orthop 205–216

  31. Fuchs T, Rottbeck U, Hofbauer V et al (2011) Pelvic ring fractures in the elderly. Underestimated osteoporotic fracture. Unfallchirurg 114:663–670. https://doi.org/10.1007/s00113-011-2020-z

    Article  CAS  PubMed  Google Scholar 

  32. Boudissa M, Francony F, Drevet S et al (2020) Operative versus non-operative treatment of displaced acetabular fractures in elderly patients. Aging Clin Exp Res 32:571–577. https://doi.org/10.1007/s40520-019-01231-5

    Article  PubMed  Google Scholar 

  33. Morrison RS, Magaziner J, Gilbert M et al (2003) Relationship between pain and opioid analgesics on the development of delirium following hip fracture. J Gerontol A Biol Sci Med Sci 58:76–81. https://doi.org/10.1093/gerona/58.1.m76

    Article  PubMed  Google Scholar 

  34. Chau DL, Walker V, Pai L, Cho LM (2008) Opiates and elderly: use and side effects. Clin Interv Aging 3:273–278. https://doi.org/10.2147/cia.s1847

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Daurka JS, Pastides PS, Lewis A et al (2014) Acetabular fractures in patients aged > 55 years: a systematic review of the literature. Bone Jt J 96B:157–163. https://doi.org/10.1302/0301-620X.96B2.32979

    Article  Google Scholar 

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Acknowledgements

The authors thank the team of physiotherapists at the Trauma Department of our center, including Cathy Beyou, Anna Chaussec, and Alicia Marchand, for their involvement in patient rehabilitation.

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Authors and Affiliations

  1. Centre Hospitalier Régional Universitaire Hôpitaux de Tours, 2 Boulevard Tonnellé, 37000, Tours, France

    Rayane Benhenneda

  2. Centre Hospitalier Régional Universitaire de Brest, Boulevard Tanguy Prigent, 29200, Brest, France

    Hoel Letissier, Frédéric Dubrana & Rémi Di Francia

Authors
  1. Rayane Benhenneda
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  2. Hoel Letissier
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  3. Frédéric Dubrana
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  4. Rémi Di Francia
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by R. Benhenneda and R. Di Francia. Analysis was performed by H. Letissier. The first draft of the manuscript was written by R. Benhenneda, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Rémi Di Francia.

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Ethics approval

The study was approved by the local ethics committee (29BRC21.0298).

Consent to participate

Informed consent to participate in the study has been obtained from participants.

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The authors declare no competing interests.

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The original version of this article was revised. The correctd data in the Conclusion in Abstract section should be: All included patients were able to walk at one day after PPS. PPS was associated with reduced pain as well as a reduction in paracetamol and morphine use.

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Benhenneda, R., Letissier, H., Dubrana, F. et al. Immediate full weight bearing after pelvic percutaneous fixation by screw for simple acetabular and pelvic ring fractures in patients older than sixty five years. International Orthopaedics (SICOT) 46, 2413–2421 (2022). https://doi.org/10.1007/s00264-022-05504-z

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  • DOI: https://doi.org/10.1007/s00264-022-05504-z

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