Treatment modalities and outcomes following acetabular fractures in the elderly: a systematic review

McCormick, Brian P; Serino, Joseph; Orman, Sebastian; Webb, Alex R.; Wang, David X.; Mohamadi, Amin; Mortensen, Sharri J.; Weaver, Michael J.; Keudell, Arvind von

doi:10.1007/s00590-021-03002-3

Cited by 22 publications

(28 citation statements)

References 48 publications

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“…The treatment options for acetabular fractures in the elderly range from conservative over minimal invasive or open reconstruction to primary or secondary hip replacement. In respect to this, a few overviews in the literature have been published the last years ( 25 , 26 ). However, during the past decades, operative treatment of acetabular fractures has developed and become a standard nowadays.…”

Section: Acetabular Fracture Treatment Needs In the Elderly And Nonag...mentioning

confidence: 99%

“…However, during the past decades, operative treatment of acetabular fractures has developed and become a standard nowadays. There are three different principles: reduction and osteosynthesis or primary total hip arthroplasty (THA) without or with a Burch–Schneider ring and lastly combined treatment methods ( 2 , 22 , 26 , 27 ). The ideal therapy regime is dependent on fracture pattern, individual risk factors and the availability of the treatment method in the trauma center.…”

Section: Acetabular Fracture Treatment Needs In the Elderly And Nonag...mentioning

confidence: 99%

“…Moreover McCormick et al . reported (2021) that a conservative therapy regime is still performed in 46.14% in a retrospective study with an average age of 72 years ( 26 ). Even if the possibility of a conservative therapy regime in acetabular fractures exists, the higher mortality rate in these cases must be considered.…”

Section: Acetabular Fracture Treatment Needs In the Elderly And Nonag...mentioning

confidence: 99%

“…2 . Comparisons of operative treatments of acetabular fractures in the elderly have shown that open reduction and internal fixation (ORIF) has been more often performed and the ilioinguinal and the intrapelvic approaches are the most commonly used ( 2 , 22 , 26 ). Besides those results, McCormick et al .…”

Section: Acetabular Fracture Treatment Needs In the Elderly And Nonag...mentioning

confidence: 99%

“…Besides those results, McCormick et al . mentioned further opportunities for treating acetabular fractures in combined (ORIF + THA) proceedings with an incidence of 3.7% or a closed reduction and percutaneous pinning (CRPP) under CT navigation with an incidence of 5.6% ( 26 ). The division of all treatment options can be seen in Fig.…”

Section: Acetabular Fracture Treatment Needs In the Elderly And Nonag...mentioning

confidence: 99%

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Acetabular fractures treatment needs in the elderly and nonagenarians

et al. 2022

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Different treatment options for acetabular fractures in the elderly and nonagenarians exist; a consistent guideline has not been established, yet. The purpose of this study is to give an overview of how those fractures can be handled and compares two different surgical treatment methods. A total of 89 patients ≥ 18 years between 2016 and 2021 with acetabular fractures in our department received a surgical intervention with plate fixation via the Stoppa approach or a total hip arthroplasty with a Burch–Schneider ring and integrated cup. 60 patients ≥ 65 were compared in two groups, 29 patients between 65 and 79 and 31 patients ≥ 80. For comparison, data on operation times, hospitalization, complications during operation and hospital stay, blood loss and postoperative mobilization were collected. Characteristics could be found for indications for operative osteosynthesis or endoprosthetics based on the X-ray analysis. There was a tendency to treat simple fractures with osteosynthesis. Patients between 65 and 79 with an osteosynthesis had benefits in almost every comparison. Patients ≥ 80 with a plate fixation had advantages in the categories of postoperative complications, blood loss and transfusion of erythrocyte concentrates. Statistical significant differences were noticed in both groups regarding the operation time. Patients between 65 and 79 with osteosynthesis had significant benefits for postoperative complications, hospitalization, number of blood transfusions and postoperative mobilization. Finding the best supportive treatment option is difficult, and decision-making must respect fracture patterns and individual risk factors. This study shows that plate fixation via the Stoppa approach has some benefits.

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Section: Acetabular Fracture Treatment Needs In the Elderly And Nonag...mentioning

confidence: 99%

Section: Acetabular Fracture Treatment Needs In the Elderly And Nonag...mentioning

confidence: 99%

Section: Acetabular Fracture Treatment Needs In the Elderly And Nonag...mentioning

confidence: 99%

Section: Acetabular Fracture Treatment Needs In the Elderly And Nonag...mentioning

confidence: 99%

Section: Acetabular Fracture Treatment Needs In the Elderly And Nonag...mentioning

confidence: 99%

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Acetabular fractures treatment needs in the elderly and nonagenarians

et al. 2022

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Acetabulum Fractures

Riemenschneider

Marzi

2023

Acute Care Surgery in Geriatric Patients

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Acetabular fractures in geriatric patients: epidemiology, pathomechanism, classification and treatment options

Krappinger,

Freude,

Stuby

et al. 2024

Arch Orthop Trauma Surg

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The incidence of geriatric acetabular fractures has shown a sharp increase in the last decades. The majority of patients are male, which is different to other osteoporotic fractures. The typical pathomechanism generally differs from acetabular fractures in young patients regarding both the direction and the amount of force transmission to the acetabulum via the femoral head. Geriatric fractures very frequently involve anterior structures of the acetabulum, while the posterior wall is less frequently involved. The anterior column and posterior hemitransverse (ACPHT) fracture is the most common fracture type. Superomedial dome impactions (gull sign) are a frequent feature in geriatric acetabular fractures as well. Treatment options include nonoperative treatment, internal fixation and arthoplasty. Nonoperative treatment includes rapid mobilisation and full weighbearing under analgesia and is advisable in non- or minimally displaced fractures without subluxation of the hip joint and without positive gull sign. Open reduction and internal fixation of geriatric acetabular fractures leads to good or excellent results, if anatomic reduction is achieved intraoperatively and loss of reduction does not occur postoperatively. Primary arthroplasty of geriatric acetabular fractures is a treatment option, which does not require anatomic reduction, allows for immediate postoperative full weightbearing and obviates several complications, which are associated with internal fixation. The major issue is the fixation of the acetabular cup in the fractured bone. Primary cups, reinforcement rings or a combination of arthroplasty and internal fixation may be applied depending on the acetabular fracture type.

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Treatment modalities and outcomes following acetabular fractures in the elderly: a systematic review

Cited by 22 publications

References 48 publications

Acetabular fractures treatment needs in the elderly and nonagenarians

Acetabular fractures treatment needs in the elderly and nonagenarians

Acetabulum Fractures

Acetabular fractures in geriatric patients: epidemiology, pathomechanism, classification and treatment options

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