Acta Chir Orthop Traumatol Cech. 2017; 84(4):241-246 | DOI: 10.55095/achot2017/038

Acetabular Fractures in an Advanced Age - Current Knowledge and Treatment OptionsCurrent concepts review

S. MÄRDIAN*, D. RAU, P. HINZ, S. WITTENBERG, M. GIESECKE, P. SCHWABE
Charité - university medicine Berlin, Centre for musculoskeletal surgery, Berlin, Germany

The demographic change in industrial countries leads to an increasing population that sustains an acetabular fracture in an advanced age. Some authors predicted elderly individuals to be the most rapidly growing subgroup of patients currently sustaining acetabular fractures. Gold standard of treatment of acetabular fractures remains the open reduction and internal fixation. Relevant factors impeding surgical treatment include the significantly decreased bone stock and the incapability of the patients to partially weight bear following surgery. Therefore, special considerations should be performed when dealing with this patient group as surgical treatment is associated with several risks and often accompanied by poor outcomes. This review aims to summarize the current body of knowledge and to give a recommendation concerning a surgical treatment cascade.

Published: August 1, 2017  Show citation

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MÄRDIAN S, RAU D, HINZ P, WITTENBERG S, GIESECKE M, SCHWABE P. Acetabular Fractures in an Advanced Age - Current Knowledge and Treatment Options. Acta Chir Orthop Traumatol Cech. 2017;84(4):241-246. doi: 10.55095/achot2017/038. PubMed PMID: 28933326.
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    References

    1. An YH (ed.). Current methods and trends in fixation in osteoporotic bone. Internal fixation of osteoporotic bone, Thieme Medical Publishers, Inc, New York, 2002, pp.73-108. Go to original source...
    2. Anglen JO, Burd TA, Hendricks KJ, Harrison P. The "Gull Sign": a harbinger of failure for internal fixation of geriatric acetabular fractures. J Orthop Trauma. 2003;17:625-634. Go to original source... Go to PubMed...
    3. Archdeacon MT, Kazemi N, Collinge C, Budde B, Schnell S. Treatment of protrusio fractures of the acetabulum in patients 70 years and older. J Orthop Trauma. 2013;27:256-261.. Go to original source... Go to PubMed...
    4. Bastian JD, Savic M, Cullmann JL, Zech WD, Djonov V, Keel MJ. Surgical exposures and options for instrumentation in acetabular fracture fixation: pararectus approach versus the modified Stoppa. Injury. 2016;47:695-701. Go to original source... Go to PubMed...
    5. Butterwick D, Papp S, Gofton W, Liew A, Beaulé PE. Acetabular fractures in the elderly: evaluation and management. J Bone Joint Surg Am. 2015;97:758-768. Go to original source... Go to PubMed...
    6. Cole JD, Bolhofner BR. Acetabular fracture fixation via a modified Stoppa limited intrapelvic approach. Description of operative technique and preliminary treatment results. Clin Orthop Relat Res. 1994;305:112-123. Go to original source...
    7. Daurka JS, Pastides PS, Lewis A, Rickman M, Bircher MD. Acetabular fractures in patients aged > 55 years: a systematic review of the literature. Bone Joint J. 2014;96-B:157-163. Go to original source... Go to PubMed...
    8. Enocson A, Blomfeldt R. Acetabular fractures in the elderly treated with a primary Burch-Schneider reinforcement ring, autologous bone graft, and a total hip arthroplasty: a prospective study with a 4-year follow-up. J Orthop Trauma. 2014;28:330-337. Go to original source... Go to PubMed...
    9. Ferguson TA, Patel R, Bhandari M, Matta JM. Fractures of the acetabulum in patients aged 60 years and older: an epidemiological and radiological study. J Bone Joint Surg Br. 2010;92:250-257. Go to original source... Go to PubMed...
    10. Gansslen A, Hildebrand F, Krettek C. Conservative treatment of acetabular both column fractures: does the concept of secondary congruence work? Acta Chir Orthop Traumatol Cech. 2012;79:411-415. Go to original source... Go to PubMed...
    11. Gary JL. Acetabular Fractures in the Elderly. Clin Med Insights. Trauma Intensive Med. 2015;6:9-17. Go to original source...
    12. Gary, J.L, Lefaivre KA, Gerold F, Hay MT, Reinert CM, Starr AJ. Survivorship of the native hip joint after percutaneous repair of acetabular fractures in the elderly. Injury, 2011. 42:1144-11451. Go to original source... Go to PubMed...
    13. Gary JL, Paryavi E, Weaver MJ, Morgan JH, Gibbons SD, Ryan SP, Starr AJ, O'Toole RV. Effect of surgical treatment on mortality after acetabular fracture in the elderly: a multicenter study of 454 patients. J Orthop Trauma. 2015;29:202-208. Go to original source... Go to PubMed...
    14. Gary JL, VanHal M, Reinert CM, Starr AJ. Functional outcomes in elderly patients with acetabular fractures treated with minimally invasive reduction and percutaneous fixation. J Orthop Trauma. 2012;26:278-283. Go to original source... Go to PubMed...
    15. Giannoudis PV, Grotz MR, Papakostidis C, Dinopoulos H. Operative treatment of displaced fractures of the acetabulum. A meta-analysis. J Bone Joint Surg Br. 2005;87:2-9. Go to original source...
    16. Jain R, Basinski A, Kreder HJ. Nonoperative treatment of hip fractures. Int Orthop. 2003;27:11-17. Go to original source... Go to PubMed...
    17. Judet R, Judet J, Letournel E. Fractures of the acetabulum: Classification and surgical approaches for open reduction. Preliminary report. J Bone Joint Surg Am. 1964;46:1615-1646. Go to original source... Go to PubMed...
    18. Keel MJ, Ecker TM, Cullmann JL, Bergmann M, Bonel HM, Büchler L, Siebenrock KA, Bastian JD. The pararectus approach for anterior intrapelvic management of acetabular fractures: an anatomical study and clinical evaluation. J Bone Joint Surg Br. 2012;94:405-411. Go to original source... Go to PubMed...
    19. Laflamme GY, Hebert-Davies J, Rouleau D, Benoit B, Leduc S. Internal fixation of osteopenic acetabular fractures involving the quadrilateral plate. Injury. 2011;42:1130-1134. Go to original source... Go to PubMed...
    20. Letournel E. [Fractures of the cotyloid cavity, study of a series of 75 cases]. J Chir (Paris). 1961;82:47-87. Go to PubMed...
    21. Letournel E. Acetabulum fractures: classification and management. Clin Orthop Relat Res. 1980;151:81-106. Go to original source...
    22. Letournel E, Judet R. Fractures of the acetabulum. Springer: New York 1993, pp.541-543. Go to original source...
    23. Lin, C, Caron J, Schmidt A, Torchia M, Templeman D. Functional outcomes after total hip arthroplasty for the acute management of acetabular fractures: 1- to 14-year follow-up. J Orthop Trauma. 2015;29:151-159. Go to original source... Go to PubMed...
    24. Lonner JH, Koval KJ. Polytrauma in the elderly. Clin Orthop Relat Res. 1995;318:136-143.
    25. Luger TJ, Luger MF. [Anesthesiological care in orthogeriatric comanagement : perioperative treatment of geriatric trauma patients]. Z Gerontol Geriatr. 2016;49:237-255. Go to original source... Go to PubMed...
    26. Manson TT, Reider L, O'Toole RV, Scharfstein DO, Tornetta P 3rd, Gary JL, the Major Extremity Trauma Research Consortium (METRC). Variation in treatment of displaced geriatric acetabular fractures among 15 level-I trauma centers. J Orthop Trauma. 2016;30:457-462. Go to original source... Go to PubMed...
    27. Mardian S, Schaser KD, Hinz P, Wittenberg S, Haas NP, Schwabe P. Fixation of acetabular fractures via the ilioinguinal versus pararectus approach: a direct comparison. Bone Joint J. 2015;97-B:1271-1278. Go to original source... Go to PubMed...
    28. Mardian S, Wichlas F, Schase, KD, Matziolis G, Füchtmeier B, Perka C, Schwabe P. Periprosthetic fractures around the knee: update on therapeutic algorithms for internal fixation and revision arthroplasty. Acta Chir Orthop Traumatol Cech. 2012;79:297-306. Go to original source... Go to PubMed...
    29. Matta JM. Operative treatment of acetabular fractures through the ilioinguinal approach. A 10-year perspective. Clin Orthop Relat Res. 1994;305:10-19. Go to original source...
    30. Matta JM. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am. 1996;78:1632-1645. Go to original source... Go to PubMed...
    31. Matta JM, Anderson LM, Epstein HC, Hendricks P. Fractures of the acetabulum. A retrospective analysis. Clin Orthop Relat Res. 1986;205:230-240. Go to original source...
    32. Mears DC. Surgical treatment of acetabular fractures in elderly patients with osteoporotic bone. J Am Acad Orthop Surg. 1999;7:128-141. Go to original source... Go to PubMed...
    33. Mears DC, Velyvis JH. Acute total hip arthroplasty for selected displaced acetabular fractures: two to twelve-year results. J Bone Joint Surg Am. 2002;84:1-9. Go to original source... Go to PubMed...
    34. Mears DC, Velyvis JH, Chang CP. Displaced acetabular fractures managed operatively: indicators of outcome. Clin Orthop Relat Res. 2003;407:173-186. Go to original source... Go to PubMed...
    35. Neuerburg C, Gosch M, Böcker W, Blauth M, Kammerlander C. [Proximal femoral fractures in the elderly]. Z Gerontol Geriatr. 2015;48:647-659; quiz 660-661. Go to original source... Go to PubMed...
    36. O'Toole RV, How often does open reduction and internal fixation of geriatric acetabular fractures lead to hip arthroplasty? J Orthop Trauma, 2014. 28(3):148-53. Go to original source... Go to PubMed...
    37. Ochs BG, Marintschev I, Hoyer H, Rolauffs B, Culemann U, Pohlemann T. Changes in the treatment of acetabular fractures over 15 years: analysis of 1266 cases treated by the German Pelvic Multicentre Study Group (DAO/DGU). Injury. 2010;41:839-851. Go to original source... Go to PubMed...
    38. Pagenkopf E, Grose A, Partal G, Helfet DL. Acetabular fractures in the elderly: treatment recommendations. HSS J. 2006;2:161-171. Go to original source... Go to PubMed...
    39. Schwabe P, Altintas B, Schaser KD, Druschel C, Kleber C, Haas NP, Maerdian S. Three-dimensional fluoroscopy-navigated percutaneous screw fixation of acetabular fractures. J Orthop Trauma. 2014;28:700-706. Go to original source... Go to PubMed...
    40. Schwabe P, Märdian S, Lucke M, Hufeland M, Buschmann CT. Complications after osteosynthetic treatment of acetabular fractures. Orthopade. 2014;43:24-34. Go to original source... Go to PubMed...
    41. Sen RK, Veerappa LA. Long-term outcome of conservatively managed displaced acetabular fractures. J Trauma. 2009;67:155-159. Go to original source... Go to PubMed...
    42. Spencer RF. Acetabular fractures in older patients. J Bone Joint Surg Br. 1989;71:774-776. Go to original source... Go to PubMed...
    43. Sullivan MP, Baldwin KD, Donegan DJ, Mehta S, Ahn J. Geriatric fractures about the hip: divergent patterns in the proximal femur, acetabulum, and pelvis. Orthopedics. 2014;37:151-157. Go to original source... Go to PubMed...
    44. Tannast M, Najibi S, Matta JM. Two to twenty-year survivorship of the hip in 810 patients with operatively treated acetabular fractures. J Bone Joint Surg Am, 2012. 94(17):1559-1567. Go to original source... Go to PubMed...
    45. Tornetta P 3rd. Displaced acetabular fractures: indications for operative and nonoperative management. J Am Acad Orthop Surg. 2001;9:18-28. Go to original source... Go to PubMed...
    46. Watts JJ, Abimanyi-Ochom J, Sanders KM. Osteoporosis costing all Australian: a new burden of disease analysis - 2012 to 2022. Osteoporosis Australia, Melbourne, Vic., 2013.

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