Background: The optimal treatment of acetabular fractures in the senior cohort is undetermined. Total hip arthroplasty in the setting of an acetabular fracture is increasing in popularity. However, there is concern regarding the fixation of a prosthetic cup in a fractured acetabulum. The purpose of this study is to map the area of stable articular surface and bone corridors available for cup fixation in this fracture cohort.
Methods: CT scans of acetabular fractures in 131 consecutive geriatric patients older than 65 years from two level 1 academic trauma centers were analyzed. Acetabular fractures were classified using the Letournel classification, the available stable articular surface, and the bone corridors available for fixation.
Results: Fractures involving the anterior column were the most common fracture type seen. The dome only pattern was the most common stable articular surface pattern. The sciatic corridor was available for fixation in all fracture types, followed by the gluteal pillar corridor. Most fractures had at least two corridors (93%) available for screw fixation.
Conclusions: The findings of this study may aid in the development and evaluation of fixation strategies for acetabular cups allowing geriatric acetabular fracture patients earlier weight bearing after primary hip arthroplasty.
[Early primary total hip arthroplasty for acetabular fractures in elderly patients].Acta Chir Orthop Traumatol Cech. 2006 Aug;73(4):275-82. Acta Chir Orthop Traumatol Cech. 2006. PMID: 17026887 Slovak.
Secure corridor for infraacetabular screws in acetabular fracture fixation-a 3-D radiomorphometric analysis of 124 pelvic CT datasets.J Orthop Surg Res. 2018 May 21;13(1):119. doi: 10.1186/s13018-018-0833-y. J Orthop Surg Res. 2018. PMID: 29784006 Free PMC article.
Treatment of periprosthetic acetabular fractures after previous hemi- or total hip arthroplasty: Introduction of a new implant.Oper Orthop Traumatol. 2016 Apr;28(2):104-10. doi: 10.1007/s00064-016-0439-7. Epub 2016 Apr 1. Oper Orthop Traumatol. 2016. PMID: 27037805 Free PMC article.
Acetabular fractures: what radiologists should know and how 3D CT can aid classification.Radiographics. 2015 Mar-Apr;35(2):555-77. doi: 10.1148/rg.352140098. Radiographics. 2015. PMID: 25763739 Review.
Acetabular Fractures.2019 Jun 22. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. StatPearls. 2020 Jan–. PMID: 31335035 Free Books & Documents. Review.