Mid-term results of the treatment of complex acetabular fractures with combined acute fixation and total hip replacement in the older patient

Abstract

Introduction: The incidence of acetabular fractures in older patients is increasing. The management of these patients is evolving due to the recognition of risks associated with prolonged immobility with conservative treatment. Materials and methods: Consecutive patients undergoing fixation and total hip replacement (THR) for displaced acetabular fractures undergoing single operation with acetabular fixation and THR were identified. Outcomes were assessed using radiographs, clinical notes, Oxford Hip Score and EuroQol-5L. Results: 77 patients were identified with 51 completing outcome scores. Mean age 68 years at time of injury. Mean follow-up 5 (2–12) years, OHS 40, EQ-5D 0.78. Revision surgery performed in 7 patients (9%). Discussion: Acute fixation combined with THR for acetabular fractures in the elderly patient, offers good functional outcomes and a low complication rate in the mid-term.

No Difference in Acute Outcomes for Patients Undergoing Fix and Replace versus Fixation Alone in the Treatment of Geriatric Acetabular Fractures

“…15,16 Furthermore, early mobilization postoperatively to avoid complications associated with immobility and prolonged bedrest are one of the primary goals, especially in geriatric acetabular fracture patients. 3,17 Thus, there has become increasing interest in performing ORIF with concurrent THA for the treatment of acetabular fractures in the elderly, a technique coined “fix and replace (FaR).” Growing evidence suggests FaR is an effective alternative approach for patients with risk factors for poor outcomes after acetabular fracture ORIF, avoiding delayed THA surgery secondary to fracture fixation failure or post-traumatic arthritis, while simultaneously permitting early mobilization. 18–29…”