Fractures of the acetabulum in patients aged 60 years and older: an epidemiological and radiological study.
Using a prospective database of 1309 displaced acetabular fractures gathered between 1980 and 2007, we calculated the annual mean age and annual incidence of elderly patients > 60 years of age presenting with these injuries. We compared the clinical details and patterns of fracture between patients > 60 years of age (study group) with those < 60 years (control group). We performed a detailed evaluation of the radiographs of the older group to determine the incidence of radiological characteristics which have been previously described as being associated with a poor patient outcome. In all, 235 patients were > 60 years of age and the remaining 1074 were < 60 years. The incidence of elderly patients with acetabular fractures increased by 2.4-fold between the first half of the study period and the second half (10% (62) vs 24% (174), p < 0.001). Fractures characterised by displacement of the anterior column were significantly more common in the elderly compared with the younger patients (64% (150) vs 43% (462), respectively, p < 0.001). Common radiological features of the fractures in the study group included a separate quadrilateral-plate component (50.8% (58)) and roof impaction (40% (46)) in the anterior fractures, and comminution (44% (30)) and marginal impaction (38% (26)) in posterior-wall fractures. The proportion of elderly patients presenting with acetabular fractures increased during the 27-year period. The older patients had a different distribution of fracture pattern than the younger patients, and often had radiological features which have been shown in other studies to be predictive of a poor outcome.
Department of Orthopaedics University of California-Davis, Sacramento, CA 95817, USA. taniaferguson@ucdmc.ucdavis.edu
T A
TA
Ferguson
R
R
Patel
M
M
Bhandari
J M
JM
Matta
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D002648:Child; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult