학술논문

Fragility Fractures of the Acetabulum: Current Concepts for Improving Patients' Outcomes.
Document Type
Article
Source
Indian Journal of Orthopaedics. Jul2022, Vol. 56 Issue 7, p1139-1149. 11p.
Subject
*INTERNAL fixation in fractures
*TOTAL hip replacement
*HIP fractures
*OPEN reduction internal fixation
*OSTEOPOROSIS
*TREATMENT effectiveness
*ACETABULUM (Anatomy)
*REOPERATION
*BONE density
*BONE fractures
Language
ISSN
0019-5413
Abstract
The incidence of fragility fractures of the acetabulum (FFA) is constantly increasing. Generally, these fractures are related to a fall on the greater trochanter involving the anterior column. The management of FFA is extremely difficult considering both patients' comorbidities and poor bone quality. Both non-operative and several operative treatment protocols are available, and the choice among them is still ambiguous. The proposed surgical techniques for FFA [namely open reduction and internal fixation (ORIF), percutaneous fixation and total hip arthroplasty (THA)] are associated with a high complication rate. The treatment with the higher early mortality is the ORIF + THA, while the one with the lowest is the non-operative. However, at longer follow-up, this difference dreadfully change is becoming the opposite. Frequently ORIF, percutaneous fixation, and non-operative treatment need a subsequent re-operation through a THA. This latter could be extremely difficult, because of poor bone quality, acetabular mal union/non-union, bone gaps and hardware retention. However, the outcomes of each of the proposed treatment are mostly poor and controverted; therefore, a comprehensive patient evaluation and an accurate fracture description are required to appropriately manage acetabular fracture in the elderly. [ABSTRACT FROM AUTHOR]