Fragility Fractures of the Acetabulum: Current Concepts for Improving Patients’ Outcomes

Toro, Giuseppe; Braile, Adriano; Cicco, Annalisa De; Pezzella, Raffaele; Ascione, Francesco; Cecere, Antonio Benedetto; Panni, Alfredo Schiavone

doi:10.1007/s43465-022-00653-0

Cited by 3 publications

(3 citation statements)

References 74 publications

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“…For this reason a significant reoperation rate for implant removal had been reported [6][7][8]. Moreover, metal wire migration and debris related to the fatigue failure of the wires might lead to both local and systemic tissue damage [3,[8][9][10]. To overcome the limitation of metal-wiringbased tension band techniques, some authors have proposed to fix patella fractures using non-absorbable sutures.…”

Section: Introductionmentioning

confidence: 99%

Modified Tension Band Wiring Using Only Non-Absorbable Braided Polyblend Sutures for the Treatment of Patellar Fractures

Itro,

De Cicco,

Conza

et al. 2024

Surgical Techniques Development

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Patellar fractures represent approximately 1% of all fractures and the pattern is influenced by the quality of the bone and the energy of the trauma. Transverse fractures are associated with extensor mechanism failure and interruption of joint congruence. Patellar fractures are generally fixed using tension band principles, through K-wires and metal cerclage. The tension band was conceived to transform the considerable tensile force applied to the patella into a compressive one to obtain a stable fixation. The use of metal implants might be associated with a significant discomfort, mostly related to the irritating action of K-wires and cerclage on the surrounding soft tissues, often leading to the need for implant removal. Therefore, we introduced an original technique for fix patellar fractures by using only a non-adsorbable braided polyblend suture. Postoperative care included progressive range of motion recovery using an articulated knee brace and a specific protocol. The suture-only tension band technique seems to be a useful technique in terms of complications and reoperation rate while allowing secure and early mobilization.

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Section: Introductionmentioning

confidence: 99%

Modified Tension Band Wiring Using Only Non-Absorbable Braided Polyblend Sutures for the Treatment of Patellar Fractures

Itro,

De Cicco,

Conza

et al. 2024

Surgical Techniques Development

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“… 3 Although the risk is exceptionally high in hip fractures, an increased mortality rate has been reported in all types of FF. 4 , 5 Most commonly, FFs could be observed in the spine, distal radius, proximal humerus, and proximal femur. 4 , 6 – 8 The latter is associated with some of the most relevant consequences of osteoporosis because of their incidence, the high level of disability, and the financial burden that is estimated to be equivalent to cardiovascular disease.…”

Section: Introductionmentioning

confidence: 99%

“… 4 , 5 Most commonly, FFs could be observed in the spine, distal radius, proximal humerus, and proximal femur. 4 , 6 – 8 The latter is associated with some of the most relevant consequences of osteoporosis because of their incidence, the high level of disability, and the financial burden that is estimated to be equivalent to cardiovascular disease. 9 The incidence of hip fractures is expected to constantly increase worldwide, 3 , 7 , 10 and the hip is the most common site of a second FF.…”

Section: Introductionmentioning

confidence: 99%

The role of the fracture liaison service in the prevention of atypical femoral fractures

Toro,

Braile,

Liguori

et al. 2023

Therapeutic Advances in Musculoskeletal

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Osteoporosis and fragility fractures (FFs) are considered critical health problems by the World Health Organization (WHO) because of high morbidity, mortality, and healthcare costs. The occurrence of a FF raises the risk of a subsequent fracture (refracture). The hip is the most common site of fragility refracture, and its onset is associated with a further increase in patient’s morbidity, mortality, and socioeconomic burden. Therefore, the prevention of refracture is essential. In this context, fracture liaison service (FLS) demonstrated to be able to reduce FF risk and also improve patients’ adherence to anti-osteoporotic treatments, particularly for bisphosphonates (BPs). However, long-term and high adherence to BPs may lead to atypical femoral fractures (AFFs). These latter are tensile side stress fractures of the femur, with high rates of complications, including delayed and non-healing. An effective FLS should be able to prevent both FF and AFF. A comprehensive and interdisciplinary approach, through the involvement and education of a dedicated team of healthcare professionals (i.e. orthopedic, geriatrician, primary care physician, rehabilitation team, and bone nurse) for evaluating both FF and AFF risks might be useful to improve the standard of care.

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Treatment Trends and Epidemiologic Changes in Acetabular Fracture Management over the Course of 10 Years: An Analysis Based on 2853 Patients as Treated by the German Pelvic Multicenter Study Group

Wittenberg,

Rau,

Paraskevaidis

et al. 2024

JCM

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Background/Objectives: Acetabular fractures, traditionally linked to high-impact trauma in younger adults, are increasingly observed in the elderly due to falls and poor bone quality. This demographic shift necessitates updated treatment approaches. This study analyzes demographic trends and treatment evolution over a decade using the German pelvic fracture registry. Methods: Data on acetabular fractures were analyzed from the German pelvic fracture registry of the German Trauma Society. Parameters included classification, demographics, treatment methods, and surgical details. Trends were assessed by grouping patients based on treatment intervals and age, comparing treatment methods, surgical approaches, and reduction quality across these groups, considering fracture types and treatment volume. Results: The study included 2853 unilateral acetabular fractures with a mean patient age of 61.5 years, showing an increasing age trend. A shift from simple to complex fractures involving the anterior acetabular column was observed. Operative treatment was performed in 62.5% of cases, more common in non-geriatric patients and those with posterior column involvement. The use of anterior intrapelvic approaches increased over time, replacing the Ilioinguinal extrapelvic approach. Anatomical reduction was achieved in 47.4% of cases, with 31.7% having imperfect reductions and 20.9% poor reductions. High-volume centers had significantly better reduction outcomes, particularly for simple fractures. Geriatric patients exhibited worse reduction quality compared to younger patients. In-hospital mortality was stable at 3.3%. Conclusions: The study highlights a demographic shift towards an older patient population, leading to more complex fracture patterns. Despite advancements in surgical techniques and new implant technologies, these demographic changes have resulted in lower reduction quality for complex fractures. Emphasis is placed on careful patient selection for reconstructive surgery or endoprosthetic replacement to ensure high-quality outcomes.

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Fragility Fractures of the Acetabulum: Current Concepts for Improving Patients’ Outcomes

Cited by 3 publications

References 74 publications

Modified Tension Band Wiring Using Only Non-Absorbable Braided Polyblend Sutures for the Treatment of Patellar Fractures

Modified Tension Band Wiring Using Only Non-Absorbable Braided Polyblend Sutures for the Treatment of Patellar Fractures

The role of the fracture liaison service in the prevention of atypical femoral fractures

Treatment Trends and Epidemiologic Changes in Acetabular Fracture Management over the Course of 10 Years: An Analysis Based on 2853 Patients as Treated by the German Pelvic Multicenter Study Group

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