title: Operative treatment of acetabular fractures in an older population through a limited ilioinguinal approach.
abstract: OBJECTIVE
  To compare treatment of acetabular fractures in elderly patients through a limited approach versus a standard ilioinguinal approach and assess changes in outcome and morbidity.
  
  
  METHODS
  Retrospective cohort comparison analysis.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Between January 1992 and January 2006, 143 patients 55 years of age or older were treated for acetabular fractures. Of these, 41 were treated through either a traditional or limited ilioinguinal approach. Patients with unilateral surgeries and a minimum follow-up of 2 years were included.
  
  
  METHODS
  Open reduction and internal fixation of acetabular fractures through a limited (lateral two windows) approach versus traditional three window ilioinguinal approach.
  
  
  METHODS
  Radiographic assessment of healing, reduction quality, progression to arthritis and total hip arthroplasty, operative time, length of stay, complications, SF-36, Musculoskeletal Functional Assessment, and the Short Musculoskeletal Functional Assessment.
  
  
  RESULTS
  The two groups were equivalent in terms of preinjury comorbidities, mechanism of injury, type and severity of fracture pattern, time to surgery, length of hospitalization, and incidence of postoperative complications. The overall rate of secondary total hip arthroplasty was 26.8% and was equivalent between the two groups. Functional outcome scores were comparable. The use of the lateral two windows was associated with a significant reduction in both blood loss and operative time.
  
  
  CONCLUSIONS
  The limited ilioinguinal approach to certain fracture patterns commonly seen in the elderly was associated with a decreased blood loss and surgical time. Moreover, there was no negative impact on outcomes in our cohort. The benefits of decreased blood loss and shorter operative time have a potential positive impact on management of these injuries.
  
  
  METHODS
  Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery, University of California, Los Angeles, Westwood, CA 90095, USA. djeffcoat@mednet.ucla.edu
authors.forename: Devon M
authors.initials: DM
authors.lastname: Jeffcoat
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: Anna N
authors.initials: AN
authors.lastname: Miller
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*; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods / Q000706:statistics & numerical data*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000601:surgery*; D007264:Inguinal Canal / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D016896:Treatment Outcome