Mehdi Boudissa1,2,3, Florent Francony4,5, Sabine Drevet4,5, Gael Kerschbaumer4,5, Sebastien Ruatti4,5, Michel Milaire4,5, Philippe Merloz4,5,6, Jérôme Tonetti4,5,6. 1. Orthopaedic and Traumatology Surgery Department, Grenoble University Hospitals, Northern Hospital, Boulevard de la Chantourne, 38700, La Tronche, France. mboudissa@chu-grenoble.fr. 2. Joseph Fourier University, Grenoble, France. mboudissa@chu-grenoble.fr. 3. TIMC-IMAG Lab, Univ. Grenoble Alpes, CNRS, UMR 5525, Pavillon Taillefer, 38700, La Tronche, France. mboudissa@chu-grenoble.fr. 4. Orthopaedic and Traumatology Surgery Department, Grenoble University Hospitals, Northern Hospital, Boulevard de la Chantourne, 38700, La Tronche, France. 5. Joseph Fourier University, Grenoble, France. 6. TIMC-IMAG Lab, Univ. Grenoble Alpes, CNRS, UMR 5525, Pavillon Taillefer, 38700, La Tronche, France.
Abstract
BACKGROUND: Acetabular fracture treatments in elderly patients are not well codified. PURPOSE: The aim of the study was to determine if, for active elderly patients, the clinical results after surgical treatment of displaced acetabular fractures are better than for non-operative treatment. METHODS: All active patients over 60 years with a Parker score higher than 6, managed for displaced acetabular fracture between 2005 and 2014, were included in this single-center retrospective study. Clinical outcomes were compared according to the therapeutic option (operative or non-operative) and the fracture pattern (anterior fracture that requires open reduction and internal fixation or posterior fracture that requires total hip arthroplasty). RESULTS: Among the 82 patients with Parker score higher than 6, 44 were treated non-operatively and 38 were operated. Forty-seven had anterior fracture (AF) and 35 had posterior fracture (PF). In the AF group, the autonomy scores were better for operative than non-operative patients (p < 0.05) with a PARKER score 7.8 (7-8) versus 5.4 (1-9); ADL score 5.7 (4-6) versus 4.4 (1-6) and IADL score 7.6 (6-8) versus 4.2 (0-8). In the PF group, the autonomy scores were better for operative than non-operative patients (p < 0.05) with a PARKER score 7.3 (4-9) versus 5.6 (2-9), ADL score 5.3 (2-6) versus 4.4 (1-6) and IADL score 5.6 (2-8) versus 4.1 (1-7). Regarding clinical outcomes, the HARRIS and PMA scores were better for operative patients (p < 0.05). CONCLUSION: Surgical treatment in elderly patients with displaced acetabular fractures is associated with better clinical outcomes than non-operative treatment when the autonomy level is comparable.
BACKGROUND: Acetabular fracture treatments in elderly patients are not well codified. PURPOSE: The aim of the study was to determine if, for active elderly patients, the clinical results after surgical treatment of displaced acetabular fractures are better than for non-operative treatment. METHODS: All active patients over 60 years with a Parker score higher than 6, managed for displaced acetabular fracture between 2005 and 2014, were included in this single-center retrospective study. Clinical outcomes were compared according to the therapeutic option (operative or non-operative) and the fracture pattern (anterior fracture that requires open reduction and internal fixation or posterior fracture that requires total hip arthroplasty). RESULTS: Among the 82 patients with Parker score higher than 6, 44 were treated non-operatively and 38 were operated. Forty-seven had anterior fracture (AF) and 35 had posterior fracture (PF). In the AF group, the autonomy scores were better for operative than non-operative patients (p < 0.05) with a PARKER score 7.8 (7-8) versus 5.4 (1-9); ADL score 5.7 (4-6) versus 4.4 (1-6) and IADL score 7.6 (6-8) versus 4.2 (0-8). In the PF group, the autonomy scores were better for operative than non-operative patients (p < 0.05) with a PARKER score 7.3 (4-9) versus 5.6 (2-9), ADL score 5.3 (2-6) versus 4.4 (1-6) and IADL score 5.6 (2-8) versus 4.1 (1-7). Regarding clinical outcomes, the HARRIS and PMA scores were better for operative patients (p < 0.05). CONCLUSION: Surgical treatment in elderly patients with displaced acetabular fractures is associated with better clinical outcomes than non-operative treatment when the autonomy level is comparable.
Entities:
Keywords:
Acetabular fracture; Autonomy level; Elderly patients; Non-operative treatment; Open reduction and internal fixation; Total hip arthroplasty
Authors: Julia Riemenschneider; Jan Tilmann Vollrath; Nils Mühlenfeld; Johannes Frank; Ingo Marzi; Maren Janko Journal: EFORT Open Rev Date: 2022-05-31
Authors: Charlotte Cibura; Emre Yilmaz; Dina Straeter; Thomas A Schildhauer; Christiane Kruppa Journal: Indian J Orthop Date: 2021-12-16 Impact factor: 1.033