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Review
. 2020 Nov-Dec;11(6):1061-1071.
doi: 10.1016/j.jcot.2020.10.029. Epub 2020 Oct 19.

Management of acetabular fractures in elderly patients

Nikhil Shah  1 , Inder P Gill  2 , Vijaya Kumar Hosahalli Kempanna  2 , Mohammad R Iqbal  2
Affiliations
Review

Management of acetabular fractures in elderly patients

Nikhil Shah et al. J Clin Orthop Trauma. 2020 Nov-Dec.

Erratum in

Abstract

Management of acetabular fractures in elderly patients is challenging. The challenges arise due to associated medical comorbidities, poor bone quality and comminution. There are multiple modalities of treatment. the exact algorithms or treatment remain undefined. Treatment is still based on experience and some available evidence. The options include conservative treatment, percutaneous fixation, open reduction internal fixation and the acute fix and replace procedure. There is a well recognised risk of each treatment option. We present a narrative review of the relevant available evidence and our treatment principles based on experience from a regional tertiary pelvic-acetabular fracture service.

Keywords: Acetabulum fractures; Combined hip procedure; Conservative; Elderly; Fix and replace; Geriatric; Percutaneous.

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Figures

Fig. 1
Fig. 1
a, b, c- 78 years, female patient, comminuted right acetabulum fracture with significant displacement, degenerative spinal scoliosis, independently mobile before fracture.
Fig. 2
Fig. 2
a, b- 3 D CT scans of the injury.
Fig. 3
Fig. 3
a,b - outcome at 3 years after conservative treatment, residual incongruity, persistent displacement, areas of malunion and non-union, despite which there was no hip pain, walks unrestricted, and swims twice a week.
Fig. 4
Fig. 4
Anterior and posterior column percutaneous screws of minimally displaced acetabulum fracture.
Fig. 5
Fig. 5
a – Right comminuted acetabulum fracture – associated both column, left acetabulum fixed 2 years earlier. The patient present with a new fracture of the right acetabulum. b, c, d. ORIF right acetabulum via AIP and first window of ilioinguinal.
Fig. 6
Fig. 6
a, b, c – comminuted left acetabulum fracture fixed using a single posterior approach and cementless ultra-porous reconstruction with bone graft.
See this image and copyright information in PMC

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