The management of complex acetabular fractures in the elderly with fracture fixation and primary total hip replacement.

Osteoporosis and associated fragility fractures are an increasing problem across the developed world. The elderly osteoporotic acetabular fracture presents a difficult problem due to high failure rates and poor outcomes. Standard management may or may not include fracture fixation, but generally includes a period of protected weight bearing, even if total hip replacement has been performed. We present a series of 12 cases of complex osteoporotic acetabular fractures in elderly patients, managed successfully using primary fracture fixation and total hip replacement with trabecular metal technology. Immediate weight bearing was allowed in all cases, few complications have been seen, and no component migration has been identified in any case.