title: Treatment of acetabular fractures in an older population.
abstract: OBJECTIVE
  To identify factors predicting poor radiographic and functional outcome and delayed total hip arthroplasty in operatively managed acetabular fractures in patients 55 years of age and older.
  
  
  METHODS
  Retrospective chart and radiographic review of a prospectively maintained database.
  
  
  METHODS
  Tertiary care hospital.
  
  
  METHODS
  Ninety-three with a mean age of 67 years met all inclusion criteria and had follow up averaging 5 years.
  
  
  METHODS
  Open reduction and internal fixation and less commonly acute total hip arthroplasty for displaced acetabular fractures in an older cohort.
  
  
  METHODS
  Three validated patient self-assessment measures were used: the Musculoskeletal Functional Assessment, the Short Musculoskeletal Functional Assessment, and the SF-36.
  
  
  RESULTS
  The overall rate of hip replacement in our study was 30.95%. Poor fracture reduction (P < 0.02), development of avascular necrosis (P < 0.001), and previous contralateral hip arthroplasty (P = 0.02) were statistically associated with the need for secondary surgeries. Functional outcome scores in the current study compared favorably with functional outcome scores reported for acetabular fractures in younger populations and with age-matched "non-injured" norms published in recent literature.
  
  
  CONCLUSIONS
  There was an acceptably low rate of major complications in 93 operatively managed fractures in this population. Nearly 70% of patients achieved functional outcomes similar to age- and injury-matched control subjects without the need for secondary surgeries. Thirty percent of patients required secondary total hip arthroplasty for posttraumatic arthritis. These patients achieved outcomes similar to patients in the other outcome groups and to injury- and age-matched norms.
authors.affiliation: Department of Orthopedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. carrolle23@hotmail.com
authors.forename: Eben A
authors.initials: EA
authors.lastname: Carroll
authors.forename: Florian G
authors.initials: FG
authors.lastname: Huber
authors.forename: Ariel T
authors.initials: AT
authors.lastname: Goldman
authors.forename: Walter W
authors.initials: WW
authors.lastname: Virkus
authors.forename: Eric
authors.initials: E
authors.lastname: Pagenkopf
authors.forename: Dean G
authors.initials: DG
authors.lastname: Lorich
authors.forename: David L
authors.initials: DL
authors.lastname: Helfet
mesh_terms: D000077:Acetabulum / Q000293:injuries* / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D059026:Diagnostic Self Evaluation; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D050723:Fractures, Bone / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011379:Prognosis; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014218:Triage