Acetabular Fractures in the Elderly: Treatment Recommendations

HSS Journal


David L. Helfet, MD

Attending Orthopedic Surgeon, Hospital for Special Surgery
Professor of Orthopaedic Surgery, Weill Cornell Medical College

Eric Pagenkopf, MD
Orthopaedic Trauma Service
Hospital for Special Surgery

Andrew Grose, MD
Orthopaedic Trauma Service
Hospital for Special Surgery

George Partal, MD
Orthopaedic Trauma Service
Hospital for Special Surgery

Abstract:
Acetabular fractures in the elderly population are marked by a high degree of variability in terms of patient and fracture characteristics. Successful outcomes depend on application of highly individualized management principles by experienced teams. Reviewed are indications and outcomes associated with various management options, including closed treatment, open reduction internal fixation, and acute or staged total hip arthroplasty. Proper initial management choices are critical, as early failures and subsequent salvage surgery can be accompanied by significant morbidity. Clinical results after ORIF closely follow the quality of articular reduction and the ability to maintain a congruent reduction of the hip joint. Fracture characteristics predictive of anatomic articular reduction should be treated with ORIF. Fracture characteristics predictive of early post-traumatic arthritis should be treated with simultaneous ORIF and THA. Presented is one referral institution's treatment algorithm and management approach.

This article appears in HSS Journal: Volume 2, Number 2.
View the full article at springerlink.com.


About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.


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