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Acetabular fracture elderly

Ran Schwarzkopf, Garwin Chin, Kelvin Kim, Dermot Murphy, Antonia F Chen
BACKGROUND: The incidence of hip fractures is growing with the increasing elderly population. Typically, hip fractures are treated with open reduction internal fixation, hemiarthroplasty, or total hip arthroplasty (THA). Failed hip fracture fixation is often salvaged by conversion THA. The total number of conversion THA procedures is also supplemented by its use in treating different failed surgical hip treatments such as acetabular fracture fixation, Perthes disease, slipped capital femoral epiphysis, and developmental dysplasia of the hip...
September 1, 2016: Journal of Arthroplasty
Z Yang, S M Röhrl, L Nordsletten
The purpose of this study is aimed to review available literatures about displaced acetabular fractures in elder patients treated with acute total hip arthroplasty. In our paper, a systematic review of the literatures about different treatment options with acute total hip arthroplastyt was represented. Furthermore, we also discussed the indications, techniques, approaches and complications and finally present a treatment recommendation based on the current articles.
February 12, 2016: West Indian Medical Journal
Valentinas Uvarovas, Igoris Šatkauskas, Robertas Urbonavičius, Vytautas Bučinskas, Julius Griškevičius, Vytautas Vengrauskas, Giedrius Petryla, Povilas Masionis, Audrius Andrijauskas, Narūnas Porvaneckas
INTRODUCTION: The total hip arthroplasty (THA) as part of acute fracture management is used for acetabular fractures in elderly patients. Our objective was to assess the stability of osteosynthesis performed using 2 different techniques in combination with THA in an experimental model. MATERIALS AND METHODS: We conducted 20 experiments using the left-side hemipelves composite bone models. There were 2 testing groups: 1- and 2-stage osteosynthesis. The acetabular fractures of the anterior column and posterior hemitransverse were simulated...
September 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Woo Lam Jo, Woo Suk Lee, Dong Sik Chae, Ick Hwan Yang, Kyoung Min Lee, Kyung Hoi Koo
Subchondral insufficiency fracture (SIF) of the femoral head occurs in the elderly and recipients of organ transplantation. Osteoporosis and deficient lateral coverage of the acetabulum are known risk factors for SIF. There has been no study about relation between spinopelvic alignment and anterior acetabular coverage with SIF. We therefore asked whether a decrease of lumbar lordosis and a deficiency in the anterior acetabular coverage are risk factors. We investigated 37 patients with SIF. There were 33 women and 4 men, and their mean age was 71...
October 2016: Journal of Korean Medical Science
Jan Svacina
A case of a traumatic periprosthetic acetabular fracture in an elderly patient, which was treated by one-stage hip exchange with implantation of an antiprotrusio cage and reconstruction of the acetabular bone loss with an injectable calcium sulphate/hydroxyapatite bone graft substitute, is reported. The paste-like bone graft substitute was injected through the holes of the antiprotrusio cage. After a setting time of 15 minutes, a low-profile cup was cemented onto the cage using polymethylmethacrylate and a new stem was inserted...
2016: Case Reports in Orthopedics
C Mauffrey, M Hake, F J Kim
The gold standard for fractures of the acetabulum is to perform an open reduction and internal fixation in order to achieve anatomical reduction. In a well-defined subset of patients, percutaneous techniques may be employed but achieving reduction by closed means can be challenging especially for fractures with large degrees of displacement. Such patient may include elderly patients who may not have the physiologic reserve to withstand open approaches. In our paper, we present a new option using laparoscopic assisted reduction of the acetabular fracture and percutaneous fixation...
October 2016: Injury
Hiroki Kobayashi, Yasuharu Nakashima, Takuaki Yamamoto, Goro Motomura, Masayuki Kanazawa, Kenji Takagishi, Yukihide Iwamoto
BACKGROUND: Excessive pelvic tilt may be one of the factors leading to instability in total hip arthroplasty (THA), even when the acetabular cup is placed properly. To our knowledge, only a few studies have described late anterior dislocation due to posterior pelvic tilt. We present 3 cases with late anterior dislocations possibly due to posterior pelvic tilt. CASES PRESENTATIONS: Case-1: An 84-years-old woman fell and presented with an anterior dislocation 12-years after THA...
2016: Open Orthopaedics Journal
A Schäffler, T Freude, F Stuby, D Höntzsch, J Veltkamp, U Stöckle, B König
Introduction: There have been significant increases in the number of acetabular fractures in elderly patients with primarily ventral pathology and medial protrusion of the femoral head. We have developed the "acetabulum wing plate", which is designed to facilitate repositioning, with its anatomically precontoured structure, and which offers full support of the quadrilateral surface, thus counteracting the force of the femoral head pushing inwards. Conventional plate osteosynthesis only provides insufficient support to the medial surface...
October 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Robert Döring, Thorsten Jentzsch, Max J Scheyerer, William Pfäffli, Clément M L Werner
BACKGROUND: Displaced femoral neck fractures are common in the elderly patient. The surgical treatment options consist of a hemiarthroplasty (HA) or total hip arthroplasty (THA). However, the best surgical choice is still under debate. Bipolar HAs do not address preexisting arthritic changes of the acetabulum, which may lead to an unfavorable clinical outcome. The purpose of the present study was to conduct a long term follow-up analysis of the bipolar hemiarthroplasty with particular focus on the influence of preoperative acetabular osteoarthritis on the functional outcome...
May 23, 2016: BMC Musculoskeletal Disorders
Aysha Rajeev, Paul Banaszkiewicz
INTRODUCTION: Hemiarthroplasty of the hip is one of the commonest procedures done for intracapsular fractures of the neck of femur in elderly. Dislocation of the hemiarthroplasty is a recognised and significant complication. This is associated with considerable morbidity and mortality. The treatment options include closed manipulation, skin and skeletal traction, conversion to total hip replacement, exploration and open reduction and leaving it out of the acetabulum. PRESENTATION OF CASE: A retrospective review of ten patients with recurrent and failed closed manipulative reduction of hemiarthroplasty who underwent revision using a cemented captive acetabular cup and cement to cement revision of femoral component with Exeter CDH stem was carried out...
2016: International Journal of Surgery Case Reports
H Resch, D Krappinger, P Moroder, M Blauth, J Becker
OBJECTIVE: Treatment of displaced periprosthetic acetabular fractures in elderly patients. The goal is to stabilize an acetabular fracture independent of the fracture pattern, by inserting the custom-made roof-reinforcement plate and starting early postoperative full weight-bearing mobilization. INDICATIONS: Acetabular fracture with or without previous hemi- or total hip arthroplasty. CONTRAINDICATIONS: Non-displaced acetabular fractures. SURGICAL TECHNIQUE: Watson-Jones approach to provide accessibility to the anterior and supraacetabular part of the iliac bone...
April 2016: Operative Orthopädie und Traumatologie
Hardik Sheth, Abhijeet-Ashok Salunke, Ramesh Panchal, Jimmy Chokshi, G-I Nambi, Saranjeet Singh, Amit Patel, Ranu Sheth
Musculoskeletal injuries following seizures have a high morbidity and mortality. These injuries are often missed and the diagnosis is delayed due to a lack of clinical suspicion and appropriate investigations.We report a case of 72 years old male with simultaneous bilateral central acetabular fracture dislocation and bilateral posterior shoulder fracture dislocation secondary to an epileptic seizure. Present study high- lights the significance of clinical suspicion and clinico-radiological evaluation for diagnosis of a rare injury following episode of seizures...
2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Wael Salama, Shazly Mousa, Abdelrahman Khalefa, Ahmed Sleem, Mohamed Kenawey, Laura Ravera, Alessandro Masse
INTRODUCTION: Surgical treatment of acetabular fractures in elderly people is challenging. The main aim of this study is to evaluate retrospectively the indications, results and the complications of simultaneous open reduction and internal fixation (ORIF) and acute total hip replacement (THR) in the management of displaced acetabular fractures. METHODS: This study was performed in an academic level I trauma centre. From January 2011 to December 2014, a consecutive series of 18 patients (eight females), with average age of 66 years (range 35-81 years) who had displaced acetabular fractures were included in our study...
March 28, 2016: International Orthopaedics
Haroon Rehman, Rhys G E Clement, Fergus Perks, Timothy O White
OBJECTIVES: Patients presenting with hip pain but normal plain radiographs may ultimately be shown on further investigation to have suffered an occult hip fracture (OHF). This diagnosis can be made with CT or MRI. Traditionally MRI has been considered a superior modality. We performed a retrospective review of all patients presenting to our service with a suspected OHF over a four-year period, investigated with either CT or MRI. DESIGN: Retrospective review. SETTING: Urban trauma centre...
June 2016: Injury
E J Mounsey, D H Williams, J R Howell, M J Hubble
Revision of a cemented hemiarthroplasty of the hip may be a hazardous procedure with high rates of intra-operative complications. Removing well-fixed cement is time consuming and risks damaging already weak bone or perforating the femoral shaft. The cement-in-cement method avoids removal of intact cement and has shown good results when used for revision total hip arthroplasty (THA). The use of this technique for the revision of a hemiarthroplasty to THA has not been previously reported. A total of 28 consecutive hemiarthroplasties (in 28 patients) were revised to a THA using an Exeter stem and the cement-in-cement technique...
December 2015: Bone & Joint Journal
Zhiping Zhou, Fei Yan, Weiping Sha, Liming Wang, Xingxiang Zhang
Hip replacement using hemiarthroplasty (HA) is a common surgical procedure in elderly patients with femoral neck fractures. However, questions remain regarding the choice of unipolar or bipolar HA. A meta-analysis of randomized, controlled trials (RCTs) was performed to determine whether bipolar HA was associated with lower rates of dislocation, reoperation, acetabular erosion, mortality, and general complications, as well as lower Harris Hip Scores, compared with unipolar HA. The authors searched PubMed and the Cochrane Register of Controlled Trials database, and 8 RCTs (including a total of 1100 patients) were selected for meta-analysis...
November 2015: Orthopedics
Jean-Christophe Bel, Jean-Paul Carret
The purpose of this study was to investigate whether minimal invasive surgery (MIS) in elderly patients with neck of femur fractures would reduce the peri-operative complications and improve the post-operative ambulation and length of hospital stay in his cohort of patients. Forty elderly patients were treated with either total hip arthroplasty (THA) or bipolar prosthesis using MIS transgluteal approach. A matched reference group treated with a conventional surgical approach formed the control group. All procedures were performed by the same surgeon...
January 2015: Injury
Dennis Z W Ng, Kevin B L Lee
INTRODUCTION: Hip hemiarthoplasties are commonly performed for displaced femoral neck fractures. Considerable differences of opinion exists regarding the choice between unipolar and bipolar designs. The main theoretical advantage of a bipolar over a unipolar prosthesis is the reduction of acetabular erosion due to movement taking place within the implant rather than at the acetabular implant interface. It is thus hypothesised that bipolar prostheses lead to better long-term functional outcomes with less complications...
June 2015: Annals of the Academy of Medicine, Singapore
M Arduini, L Saturnino, A Piperno, R Iundusi, U Tarantino
BACKGROUND: With increasing life expectancy, fragility fractures of the pelvic ring (FFP) are becoming frequent. In elderly, osteoporosis leads to a decrease of bone strength and resistance to the ligament's traction; this represents the most important difference between FFP and fractures in young patients. Usually, these fractures are underestimated and treatment is often conservative. AIMS: To evaluate clinical and surgical outcomes of surgically treated patients with FFP...
October 2015: Aging Clinical and Experimental Research
Adham Abdelfattah, Michael Del Core, Lisa K Cannada, J Tracy Watson
BACKGROUND: The impact of orthopedic injuries in the elderly patient with multi-trauma and the effect of operative fixation on these injuries have not been thoroughly evaluated. METHODS: We reviewed geriatric patients (aged 65 and older) between 2004 and 2010 at a level 1 trauma center who sustained high-energy polytrauma (injury and severity score [ISS] ≥ 16) with associated orthopedic injuries. Patients were excluded if they had severe head and spine injuries, died on arrival, or had low-energy mechanisms of injury...
December 2014: Geriatric Orthopaedic Surgery & Rehabilitation
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