Acetabular fractures over 60

Fractures of the acetabulum in patients aged 60 years and older: an epidemiological and radiological study.

Ferguson TA, Patel R, Bhandari M, et al. The Journal of bone and joint surgery. British volume 2010 · PMID 20130318 · doi:10.1302/0301-620x.92b2.22488

Question

How do acetabular fracture patterns in patients aged 60 and over differ from those in younger patients?

Design

Review of a prospectively maintained single-surgeon database of displaced acetabular fractures collected over nearly three decades.

Patients

Patients with acetabular fractures, comparing those aged 60 years and older with younger patients.

Intervention

Not applicable (epidemiological comparison)

Comparison

Younger patients

Primary outcome

Fracture pattern and radiological features

Key result

The share of patients over 60 rose significantly over the study period. Older patients significantly more often had fractures involving displacement of the anterior column, frequently with a separate quadrilateral plate fragment or roof impaction, while their posterior wall fractures often showed comminution and marginal impaction, features linked to poorer outcomes.

Limitations

Single-centre referral database, so selection bias is likely; no functional outcomes.

Impact on practice

Highlights that geriatric acetabular fractures are a distinct, growing problem with poor-prognosis features, informing decisions on non-operative care, fixation or acute total hip arthroplasty.