Fractures of the acetabulum in elderly patients: An update

Guerado, Enrique; Cano, Juan Ramón; Cruz, Encarnación

doi:10.1016/s0020-1383(13)70177-3

Cited by 66 publications

(54 citation statements)

References 68 publications

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“…However, the patient selection in the elderly is crucial in order to obtain good outcome. For those whose general health condition contraindicates surgery, conservative management is the treatment of choice 14 .…”

Section: Discussionmentioning

confidence: 99%

Outcome of Surgical Treatment for Displaced Acetabular Fractures

Anizar-Faizi

Hisam

et al. 2014

MOJ

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The aim of this study was to assess the outcome of surgical treatment in displaced acetabular fractures in our local facilities. Previous studies reveal good outcome via open reduction method with achievement of congruent joint. We note that studies in this respect have not been conducted in our region. We retrospectively analyzed thirty patients with acetabular fractures who underwent open reduction and internal fixation. The data collection was performed over a 4-year period, from 2008 to 2011. The results showed 20 out of 30 patients (66.7%) had excellent/good results (Harris Hip Score equal or more than 80). Post operative complications were deep infection (6.7%), iatrogenic sciatic nerve injury (10.0%), avascular necrosis (16.7%), heterotopic ossificans (3.3%), degenerative changes in hip joint (43.3%) and loss of reduction (3.3%). In conclusion, surgical treatment of displaced acetabular fractures produces good functional outcome despite the complications.

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Section: Discussionmentioning

confidence: 99%

Outcome of Surgical Treatment for Displaced Acetabular Fractures

Anizar-Faizi

Hisam

et al. 2014

MOJ

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“…For complex fracture types, the trend is toward less invasive single approaches [29]. When there is a separation of both columns and displacement of a quadrilateral plane fragment, sufficient fragment retention remains demanding, particularly in older patients with osteoporotic bone quality or when single approaches are used [12]. Therefore, several modifications for iliopectineal plate fixation through common anterior approaches (Letournel's ilioinguinal [21], modified Stoppa-Rives [6], or anterior intrapelvic approach [34]) have been described.…”

Section: Introductionmentioning

confidence: 99%

Sex-specific Differences of the Infraacetabular Corridor: A Biomorphometric CT-based Analysis on a Database of 523 Pelves

Gras

Gottschling

Schröder

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background An infraacetabular screw path facilitates the closure of a periacetabular fixation frame to increase the plate fixation strength in acetabular fractures up to 50%. Knowledge of the variance in corridor sizes and axes has substantial surgical relevance for safe screw placement. Questions/purposes (1) What proportion of healthy pelvis specimens have an infraacetabular corridor that is 5 mm or larger in diameter? (2) Does a universal corridor axis and specific screw entry point exist? (3) Are there sex-specific differences in the infraacetabular corridor size or axis and are these correlated with anthropometric parameters like age, body weight and height, or the acetabular diameter? Methods A template pelvis with a mean shape from 523 segmented pelvis specimens was generated using a CTbased advanced image analyzing system. Each individual pelvis was registered to the template using a free-form registration algorithm. Feasible surface regions for the entry and exit points of the infraacetabular corridor were marked on the template and automatically mapped to the individual samples to perform a measurement of the maximum sizes and axes of the infraacetabular corridor on each specimen. A minimum corridor diameter of at least 5 mm was defined as a cutoff for placing a 3.5-mm cortical screw in clinical settings. Results In 484 of 523 pelves (93%), an infraacetabular corridor with a diameter of at least 5 mm was found. Using the mean axis angulations (54.8°[95% confidence interval {CI}, 0.6] from anterocranial to posterocaudal in relation to the anterior pelvic plane and 1.5°[95% CI, 0.4] from anteromedial to posterolateral in relation to the sagittal midline plane), a sufficient osseous corridor was present in 64% of pelves. Allowing adjustment of the three-dimensional axis by another 5°included an additional 25% of pelves. All corridor parameters were different between females and males (corridor diameter, 6.9 [95% CI, 0

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“…According to epidemiology data, the incidence of acetabular fractures is approximately three per 100 000 per year [3]. They usually result from intense injuries and often occur in multiple trauma patients [4]. However, fragility acetabular fractures in osteoporotic patients can occur as a result of simple low energy falls from standing height or minor trauma [5].…”

Section: Introductionmentioning

confidence: 99%

Outcome after Surgical Management of Acetabular Fractures: A 7-Year Experience

Mesbahi

Ghaemmaghami

et al. 2018

BEAT

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Objective: To determine the functional and radiologic results of surgical treatment in patients with acetabular fractures. Methods: This was a retrospective cross-sectional study. We retrospectively reviewed medical records of patients operatively treated acute acetabular fractures at a level I trauma center (Shahid Rajaee) and an orthopedic center (Shahid Chamran) both in southern Iran (Shiraz) with minimally 1 year follow up over a period of 7 years from April 2009 to March 2016. Functional and radiographic outcomes, and complication were considered as main outcomes. Results: A total number of 79 patients completed the study. Fifty-five patients were operated through KocherLangenbeck approach, and 18 were operated through the standard ilioinguinal approach, and 6 patients were operated through the standard ilioinguinal approach combined with Kocher-Langenbeck approach. The mean follow-up of patients was 45.6 months. The average operative time was 162.4±78.5 min, and the median blood loss was 500 ml. Functional results were excellent in 41 patients (51.9%), good in 12 (15.2%), fair in 13 (16.5%), and poor in 13 patients (16.5%). Radiologic results were excellent in 27 cases (34.2%), good in 17 cases (21.5%), fair in 18 cases (22.8%), and poor in 16 (16.5%). Osteoarthritis of hip (60.8%) and AVN of head of femur (22.8%) were two most common complications. In addition, there wasn't any significant difference between surgical approaches regarding clinical and radiographic outcomes. Conclusion: The operative treatment for acetabular fractures gives universally satisfactory results. Thereafter, this study provides evidence that ilioinguinal approach is a good choice for anterior fractures, KocherLangenbeck is a good choice for posteriors fractures, and combined approach may be a good choice in the management of acetabular fractures involving two columns.

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Fractures of the acetabulum in elderly patients: An update

Cited by 66 publications

References 68 publications

Outcome of Surgical Treatment for Displaced Acetabular Fractures

Outcome of Surgical Treatment for Displaced Acetabular Fractures

Sex-specific Differences of the Infraacetabular Corridor: A Biomorphometric CT-based Analysis on a Database of 523 Pelves

Outcome after Surgical Management of Acetabular Fractures: A 7-Year Experience

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