Acetabular fractures in the elderly continue to pose a major public health issue and a treatment challenge for orthopedic surgeons. Controversy remains regarding the role of nonoperative management, minimally invasive techniques, open reduction internal fixation, and acute total hip arthroplasty. The goals of acetabular fracture treatment in the elderly population should not be different from their younger cohorts and should include rapid mobilization and attempts to return the patient to their baseline level of function. These goals, however, can be complicated by medical comorbidities, preexisting degenerative joint disease, and poorer bone quality. This chapter reviews the current evidence with the aim of providing further guidance to aid decision-making. Irrespective of treatment choice, details including options, planning, technical tricks, etc., are outlined.
Acetabular fractures Elderly Management Operative indications Open reduction and internal fixation Surgical planning Technical tricks
This is a preview of subscription content, log in to check access.
Letournel E. The treatment of acetabular fractures through the ilioinguinal approach. Clin Orthop Relat Res. 1993;292:62–76.CrossRefGoogle Scholar
Judet R, Judet J, Letournel E. Fractures of the acetabulum: classification and surgical approaches or open reduction. Preliminary report. J Bone Joint Surg Am. 1964;46:1615–46.CrossRefGoogle Scholar
Jeffcoat DM, Carroll EA, Huber FG, Goldman AT, Miller AN, Lorich DG, et al. Operative treatment of acetabular fractures in an older population through a limited ilioinguinal approach. J Orthop Trauma. 2012;26(5):284–9.CrossRefGoogle Scholar
Ebraheim NA, Lu J, Biyani A. Anatomic considerations of the principal nutrient foramen and artery on internal surface of the ilium. Surg Radiol Anat. 1997;19(4):237–9.CrossRefGoogle Scholar
Kottmeier S, Farcy J, Baruch H. The ilioinguinal approach to acetabular fracture management. Oper Tech Orthop. 1993;3(1):60–70.CrossRefGoogle Scholar
Hospodar P, Ashman E, Traub J. Anatomic study of the lateral femoral cutaneous nerve with respect to the ilioinguinal surgical dissection. J Orthop Trauma. 1999;13(3):207–11.CrossRefGoogle Scholar
Matta J. Operative treatment of acetabular fractures through the ilioinguinal approach. A 10 year perspective. Clin Orthop Relat Res. 1994;305:10–9.CrossRefGoogle Scholar
Teague D, Graney D, Routt ML Jr. Retropubic vascular hazards of the iliioinguinal exposure: a cadaveric and clnical study. J Orthop Trauma. 1996;10(3):156–9.CrossRefGoogle Scholar
Carroll EA, Huber FG, Goldman AT, Virkus WW, Pagenkopf E, Lorich DG, et al. Treatment of acetabular fractures in an older population. J Orthop Trauma. 2010;24(10):637–44.CrossRefGoogle Scholar