title: Displaced acetabular fractures in the elderly: results after open reduction and internal fixation.
abstract: BACKGROUND
  The optimal management of elderly patients with displaced acetabular fractures remains controversial. This paper aims to summarize the clinical results of open reduction and internal fixation (ORIF) and the possible factors influencing them.
  
  
  METHODS
  Radiographic and clinical data on 52 elderly patients with displaced acetabular fractures that were treated by ORIF between May 2000 and May 2008 were retrospectively analysed. Data, such as fracture type (Letournel's classification system), quality of reduction, clinical outcomes (Harris hip score and modified Merle d'Aubigne-Postel score), and radiological outcomes (Matta score), were evaluated.
  
  
  RESULTS
  Good to excellent clinical and radiological outcomes were recorded in 43 (82.7%) and 37 patients (71.2%), respectively. Acetabular fractures without radiographic features, such as quadrilateral plate fracture, Gull sign, posterior dislocation of hip, posterior wall marginal impaction, comminuted posterior wall fracture, and femoral head injury, can still achieve good to excellent outcomes. However, patients with the abovementioned radiographic features tend to achieve fair or poor outcomes. When an acetabular fracture with the aforementioned features, except for femoral head injury, can achieve and maintain anatomic reduction until complete fracture healing, the difference between fractures with and without the radiographic features is no longer significant. The results indicate that the outcomes are more affected by reduction rather than radiographic features.
  
  
  CONCLUSIONS
  ORIF may be suggested for displaced acetabular fractures in the elderly. Good to excellent outcomes and a high degree of patient satisfaction can be achieved in majority of the patients. We recommend ORIF as the preferred treatment for displaced acetabular fractures without the abovementioned radiographic features.
  
  
  METHODS
  Therapeutic level IV.
authors.affiliation: Orthopedic Trauma Department, The Central Hospital of Zaozhuang Mining Group of Shandong, Qilianshan Road, High-tech Zone, Zaozhuang, Shandong 277800, PR China. Electronic address: 1525806248@qq.com.
authors.forename: Yuan-Lei
authors.initials: YL
authors.lastname: Li
authors.affiliation: Orthopedic Trauma Department, The Central Hospital of Zaozhuang Mining Group of Shandong, Qilianshan Road, High-tech Zone, Zaozhuang, Shandong 277800, PR China.
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Tang
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Acetabular fracture; Elderly patients; Outcome; Radiographic feature