Stabilization of acetabular fractures in elderly patients.

Helfet, David L.; Borrelli, Joseph; DiPasquale, Thomas; Sanders, Roy

doi:10.2106/00004623-199274050-00015

Cited by 184 publications

(115 citation statements)

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“…Helfet et al 13 , reported good to excellent outcomes at three years in 18 patients with an average age 67 years. But several of the patients had significant risk factors suggesting potential need for future total hip replacement.…”

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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“…In addition, most surgeons employ restricted weightbearing for 6 to 12 weeks after acetabular fracture surgery, something that elderly patients are often not able to adhere to, resulting in secondary loss of fracture reduction. There is little in the literature suggesting good outcomes with fixation of the elderly acetabular fracture [2,11,13,31,35]. We therefore evaluated a treatment algorithm that involved fracture fixation plus THA and immediate weightbearing in selected older patients with acetabular fractures.…”

Section: Discussionmentioning

confidence: 99%

“…We are not aware of any large series in the literature where acetabular fractures have been managed surgically, employing early full weightbearing, with the exception of cases where the original fracture was a simple posterior pattern. Helfet et al [11] managed their patients with conventional fixation, followed by a period of toe touch weightbearing, and Mears [24], despite using primary arthroplasty, also protected weightbearing for 6 weeks. In this select group of patients, we believe that early weightbearing should be a key part of the management strategy, for both patient-and hospital-related reasons.…”

Section: Discussionmentioning

confidence: 99%

“…These complication rates compare favorably with other published series treating elderly acetabular fractures. Helfet et al [11] treated 18 patients with fixation alone and had a complication rate of two pulmonary emboli (11%), one intraoperative fracture (6%), one retained fragment (6%), one loss of reduction (6%), one rapid progression to osteoarthrosis (6%), and one gastrointestinal bleed (6%). Matta's [22] series of fixations of elderly acetabular fractures saw a rapid postoperative arthrosis rate of 5%.…”

Section: Discussionmentioning

confidence: 99%

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Managing Acetabular Fractures in the Elderly With Fixation and Primary Arthroplasty: Aiming for Early Weightbearing

Rickman

Young

Trompeter

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Osteoporotic acetabular fractures in the elderly are becoming more common. Regardless of treatment, most patients are managed with a period of protected weightbearing, even if a THA has been performed. We have tried to treat these patients analogously to geriatric femoral neck fractures in a way that allows immediate full weightbearing. Questions/purposes We determined return to mobility, length of hospital stay (LOS), radiographic outcomes, and complications in a series of elderly osteoporotic patients treated for acetabular fractures with early fracture fixation and simultaneous THA, allowing full weightbearing immediately postoperatively. Methods Since 2009, one surgeon (MR) used a consistent approach for fracture fixation and THA with immediate weightbearing in all patients older than 65 years with acetabular fractures who were fit for surgery and whose injuries were deemed osteoporotic fractures (low-energy mechanisms) meeting particular radiographic criteria (significant marginal impaction or femoral head damage). Twenty-four patients met these criteria and were reviewed at a mean of 24 months (range, 8-38 months). Mean age was 77 years (range, 63-90 years), and eight patients were women. The surgical technique included plate stabilization of both acetabular columns plus simultaneous THA using a tantalum socket and a cemented femoral stem. Clinical and note reviews were conducted to ascertain return to mobility, LOS, and postoperative complications. Component migration and fracture healing were assessed on plain radiographs.

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“…They are also frequently associated with traumatic hip joint dislocations. [1][2][3] As a consequence of acetabular fractures, three possible late post-traumatic complications potentially require reconstructive surgery: post-traumatic osteoarthritis (OA), avascular femoral head necrosis (AVN) and heterotopic ossification (HO). According to data from the literature, the ratio of OA varies in a wide range (5-56%), depending on fracture pattern, Short-term results of total hip replacement after acetabular fractures grade of fragment displacement and successfulness of the primary osteosynthesis; the ratio of AVN is determined at a range of 4-29%.…”

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confidence: 99%