Abstract
Background
This study aimed to determine characteristics of acetabular fractures in the elderly
by evaluating clinical course and computed tomography-based radiological features
between low- and high-energy acetabular fractures.
Methods
We reviewed 178 consecutive patients with acetabular fractures aged ≥60 years from
six centers. Low-energy fractures (group 1) were identified in 23 (12.9%) patients
and high-energy fractures (group 2) in 155 (87.1%) patients. We compared demographics,
radiological findings, and clinical course between the groups.
Results
Average age (70.6 vs. 67.8 years, p = 0.046) and ratio of females (47.8% vs. 23.2%,
p = 0.021) were significantly higher in group 1 than in group 2. The Charlson comorbidity
index was also higher in group 1, but no other demographics showed difference. More
patients in group 2 than in group 1 underwent surgery (91.6% vs. 73.9%); however,
more in group 1 underwent minimally invasive surgery (17.4% vs 4.5%). Anterior column-associated
fracture patterns occurred in 91.4% and 38.7% of cases in groups 1 and 2, respectively.
Most fractures were displaced (>2 mm); 68% of which were comminuted. Furthermore,
24.2% of the fractures had superior dome impaction, whereas 23.0% were associated
with posterior wall impaction.
Conclusions
Patients who sustained low-energy acetabular fractures were mostly women, were older,
and had more comorbidities. Radiological findings of low-energy acetabular fractures
showed anterior column involvement associated with injury to the quadrilateral surface.
Additionally, it was observed to be commonly combined with comminution and impacted
fragments.
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Article info
Publication history
Published online: December 28, 2021
Accepted:
December 8,
2021
Received in revised form:
December 5,
2021
Received:
November 28,
2020
Identification
Copyright
© 2021 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
