Acetabular Fractures in Elderly Patients: Alternatives to Open Reduction and Internal Fixation

Abstract

In recent years, there has been a dramatic increase in the number of elderly patients who present with an acetabular fracture. The combination of advanced age and the osteoporosis inherently present in elderly patients predisposes to acetabular fracture comminution and articular impaction, both of which have been identified as risk factors for poor outcomes with open reduction and internal fixation. Given the relatively poor results with this treatment modality and the comorbidities often present in this patient population, alternative treatment methods are important. No consensus about the optimal management of acetabular fractures in elderly patients has been established; therefore, individualization of treatment is important. Treatment alternatives include nonsurgical treatment with mobilization, traction with or without delayed total hip arthroplasty, femoral head resection with or without delayed hip arthroplasty, limited percutaneous fixation, and acute total hip arthroplasty.

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