학술논문
Fragility Fractures of the Acetabulum: Current Concepts for Improving Patients' Outcomes.
Document Type
Article
Author
Source
Subject
*Internal fixation in fractures
*Total hip replacement
*Hip fractures
*Open reduction internal fixation
*Osteoporosis
*Treatment effectiveness
*Acetabulum (Anatomy)
*Reoperation
*Bone density
*Bone fractures
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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]