Acetabular fractures in elderly patients: a comparative study of low-energy versus high-energy injuries.
OBJECTIVE
The goal of this study is to compare the characteristics, clinical course, and mortality rates of acetabular fractures in the elderly population with respect to two types of injury.


METHODS
We reviewed 183 consecutive patients with acetabular fractures aged 60 years old and older. One hundred eighty-three patients (129 men and 54 women) were included in the study with an average age of 70.2 years. There were 186 fractures, which included three cases of bilateral fractures. Patients were divided into two groups: low-energy injuries (group I), 56, and high-energy injuries (group II), 130. Patient characteristics and fracture pattern, as well as in-hospital mortality rates were compared between the low-energy and high-energy groups.


RESULTS
Patient demographics and comorbidities were significantly different between the groups. In group I, the average age was 74.9 years, versus 68.2 years in group II (p < 0.001). The percent of females in each group was 39.3 % and 24.6 %, respectively (p = 0.043), and the average body mass index (BMI) was 25.6 and 28.4, respectively (p = 0.001). The Charlson comorbidity index was higher in group I (1.98 vs 0.95 in group II, p < 0.001). However, the American Society of Anesthesiologists physical status (ASA) was similar between groups (2.56 vs 2.53, respectively, p = 0.808). The proportion of surgical treatment was 44.6 % in group I and 61.6 % in group II (p = 0.019). Group II had a longer hospital stay (10.4 days vs 14.5 days, p = 0.025), but in-hospital death was not significantly different (5.3 % vs 7.9 %, respectively, p = 0.567).


CONCLUSIONS
Patients with acetabular fractures resulting from low-energy injuries were older and had lower BMI with more comorbidities. This study may highlight characteristics of fragility fractures of the acetabulum.
Haeundae Paik Hospital, Department of Orthopaedic Surgery, Inje University, Busan, Republic of Korea.
Ji Wan
JW
Kim
Benoit
B
Herbert
Jiandong
J
Hao
William
W
Min
Bruce H
BH
Ziran
Cyril
C
Mauffrey
D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000077:Acetabulum / Q000293:injuries* / Q000601:surgery; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D050723:Fractures, Bone / Q000145:classification / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors