L’arthroplastie totale de hanche dans le traitement des fractures récentes de l’acétabulum du sujet âgé

Cochu, G.; Mabit, C.; Gougam, T.; Fiorenza, F.; Baertich, C.; Charissoux, J.-L.; Arnaud, J.

doi:10.1016/s0035-1040(07)78465-9

Cited by 32 publications

(5 citation statements)

References 25 publications

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“…Five studies 6 , 9 , 10 , 15 , 16 presented the results of a combined procedure of internal fixation (IF) and THA; three studies 5 , 8 , 17 evaluated the results of THA alone. The surgical approaches most commonly used were a posterior approach in 76.9% and lateral approach in 23.1% of the cases.…”

Section: Resultsmentioning

confidence: 99%

“…In three studies, 9 , 10 , 15 standard ORIF prior THA implantation was used. Cochu et al 8 and Malhotra et al 15 used different types of reinforcement rings to fix the acetabular component to the ilium. In Enocson and Blomfeldt’s 17 and Tidermark et al’s 5 series a Burch–Schneider antiprotrusio cage (Zimmer, Warsaw, Indiana) was adjusted and fixed to the pelvis using two to five screws in the intact part of the ileum.…”

Section: Resultsmentioning

confidence: 99%

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Surgical treatment of acetabular fractures in the elderly: a systematic review of the results

2017

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We performed a systematic review of the literature involving a number of databases to identify studies that included outcomes of surgical treatment of acetabular fractures in patients aged > 55 years. An initial search identified 1564 studies. After exclusion by two independent reviewers, 15 studies met the inclusion criteria. All studies were case series and the mean Coleman Methodology score for methodological quality assessment was 43.7 (standard deviation 12.3). There were 354 patients with acetabular fractures. Pooled analysis revealed a mean age of 71.6 years (55 to 96) and a mean follow-up of 43 months (20 to 188). Complex fractures were reported in 70.1% of patients.Seven studies presented the results of open reduction and internal fixation (ORIF); in eight other studies a total hip arthroplasty (THA), alone or combined with different internal fixation techniques, was the chosen treatment. In the ORIF sub-group, conversion to THA was performed at a mean of 25.5 months with anatomical reduction in 11.6% and imperfect and poor reduction in 22.3%. In the THA sub-group, an acetabular ring or cage with a cemented acetabular component was used in four studies (52 patients) and a cementless acetabular component was implanted in five studies (78 patients). Six patients (4.9%) underwent revision at a mean of 39 months after the index procedure.The analysis of intra-operative and post-operative parameters showed a statistical difference between the two sub-groups with regards to the mean operating time (236 mins ORIF vs 178 mins THA), the mean blood loss (707 mL ORIF vs 974 mL THA) and the mean mortality rate at one year (22.6% ORIF vs 8.8% THA).Based on the current data available, acute THA (alone or in combination with internal fixation) may have a role in the treatment of older patients with complex acetabular fractures. Despite the wide heterogenecity of fracture types and patient co-morbidities, THA procedures were associated with lower rates of mortality and further surgery when compared with the ORIF procedures.Cite this article: EFORT Open Rev 2017;2:97-103. DOI: 10.1302/2058-5241.2.160036

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Surgical treatment of acetabular fractures in the elderly: a systematic review of the results

2017

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“…It is also associated with a shorter operating time and lower rate of mortality than osteosynthesis [30] . Patients have full functional recovery with immediate loading and excellent results in the short and medium term with minimal complications [27] , [28] , [31] , [32] , [33] . Mean time from fall to surgery remains to be between 1 day and 6 weeks to be considered as an early treatment [27] , [30] , [31] .…”

Section: Discussionmentioning

confidence: 99%

Early simultaneous bilateral total hip arthroplasty for the management of bilateral acetabular fracture in an elderly patient

2019

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Bilateral acetabular fractures in elderly patients due to seizures are very rare and management is a challenge. The standard treatment for acetabular fracture, open reduction with internal fixation, is not recommended for the elderly because of poor bone quality and the need for bed rest. In the acute phase, total hip arthroplasty may be the best treatment option because it allows early mobilization and avoids bed rest complications. We report the case of a 76-year-old man with a bilateral comminuted acetabular fractures and a left fracture dislocation of the shoulder, treated by immediate shoulder arthroplasty and a one-stage bilateral total hip arthroplasty procedure at 3 weeks, with a good result at 1-year follow-up.

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“…The ORIF is also not the best option because of osteoporotic bone and lengthy decubitus position. 4 Moreover, although ORIF requires 1 surgery, a secondary THA may be needed in the future because of osteoarthritis. 5 …”

Section: Introductionmentioning

confidence: 99%

Different Stabilization Techniques for Type 62B3 Acetabular Fractures in Combination With Primary Total Hip Arthroplasty in Elderly Patients

Uvarovas

Šatkauskas

Urbonavičius

et al. 2016

Geriatr Orthop Surg Rehabil

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Introduction:The total hip arthroplasty (THA) as part of acute fracture management is used for acetabular fractures in elderly patients. Our objective was to assess the stability of osteosynthesis performed using 2 different techniques in combination with THA in an experimental model.Materials and Methods:We conducted 20 experiments using the left-side hemipelves composite bone models. There were 2 testing groups: 1- and 2-stage osteosynthesis. The acetabular fractures of the anterior column and posterior hemitransverse were simulated. The same THA technique was used in both groups. The stability of osteosynthesis was explored and compared between the groups by measuring the fracture displacement of anterior and posterior columns under the standardized test load (1187 N) protocol. Load distance diagrams were generated.Results:The 0.680-mm gap (0.518; 1.548) of the posterior column in the 1-stage group (n = 10) was higher than the 0.370-mm gap (0.255; 0.428) in the 2-stage group (n = 10; P = .002). There was no significant difference between the gap of the anterior column in the 1- and 2-stage groups (0.135 [0.078; 0.290] mm vs 0.160 [0.120; 0.210] mm; P = .579).Conclusion:The 2-stage osteosynthesis of the anterior and posterior columns in combination with THA provides better stability of posterior column when compared to 1-stage method in composite bone models.

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L’arthroplastie totale de hanche dans le traitement des fractures récentes de l’acétabulum du sujet âgé

Cited by 32 publications

References 25 publications

Surgical treatment of acetabular fractures in the elderly: a systematic review of the results

Surgical treatment of acetabular fractures in the elderly: a systematic review of the results

Early simultaneous bilateral total hip arthroplasty for the management of bilateral acetabular fracture in an elderly patient

Different Stabilization Techniques for Type 62B3 Acetabular Fractures in Combination With Primary Total Hip Arthroplasty in Elderly Patients

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