Treatment of acetabular fractures in an older population.
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.
Carroll
Eben A
EA
Department of Orthopedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. carrolle23@hotmail.com
Huber
Florian G
FG
Goldman
Ariel T
AT
Virkus
Walter W
WW
Pagenkopf
Eric
E
Lorich
Dean G
DG
Helfet
David L
DL
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