SpringerLink
Log in

Acetabular fractures in elderly patients: a comparative study of low-energy versus high-energy injuries

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

The goal of this study is to compare the characteristics, clinical course, and mortality rates of acetabular fractures in the elderly population with respect to two types of injury.

Methods

We reviewed 183 consecutive patients with acetabular fractures aged 60 years old and older. One hundred eighty-three patients (129 men and 54 women) were included in the study with an average age of 70.2 years. There were 186 fractures, which included three cases of bilateral fractures. Patients were divided into two groups: low-energy injuries (group I), 56, and high-energy injuries (group II), 130. Patient characteristics and fracture pattern, as well as in-hospital mortality rates were compared between the low-energy and high-energy groups.

Results

Patient demographics and comorbidities were significantly different between the groups. In group I, the average age was 74.9 years, versus 68.2 years in group II (p < 0.001). The percent of females in each group was 39.3 % and 24.6 %, respectively (p = 0.043), and the average body mass index (BMI) was 25.6 and 28.4, respectively (p = 0.001). The Charlson comorbidity index was higher in group I (1.98 vs 0.95 in group II, p < 0.001). However, the American Society of Anesthesiologists physical status (ASA) was similar between groups (2.56 vs 2.53, respectively, p = 0.808). The proportion of surgical treatment was 44.6 % in group I and 61.6 % in group II (p = 0.019). Group II had a longer hospital stay (10.4 days vs 14.5 days, p = 0.025), but in-hospital death was not significantly different (5.3 % vs 7.9 %, respectively, p = 0.567).

Conclusion

Patients with acetabular fractures resulting from low-energy injuries were older and had lower BMI with more comorbidities. This study may highlight characteristics of fragility fractures of the acetabulum.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Mears DC (1999) Surgical treatment of acetabular fractures in elderly patients with osteoporotic bone. J Am Acad Orthop Surg 7(2):128–141

    CAS  PubMed  Google Scholar 

  2. WHO (1998) Guidelines for preclinical evaluation and clinical trials in osteoporosis. World Health Organization, Geneva

  3. Dell R, Greene D, Schelkun SR, Williams K (2008) Osteoporosis disease management: the role of the orthopaedic surgeon. J Bone Joint Surg Am 90(Suppl 4):188–194. doi:10.2106/JBJS.H.00628

    Article  PubMed  Google Scholar 

  4. Lin JT, Lane JM (2004) Osteoporosis: a review. Clin Orthop Relat Res 425:126–134

    Article  PubMed  Google Scholar 

  5. Rowe SM, Yoon TR, Ryang DH (1993) An epidemiological study of hip fracture in Honam, Korea. Int Orthop 17(3):139–143

    CAS  PubMed  Google Scholar 

  6. Carretta E, Bochicchio V, Rucci P, Fabbri G, Laus M, Fantini MP (2011) Hip fracture: effectiveness of early surgery to prevent 30-day mortality. Int Orthop 35(3):419–424. doi:10.1007/s00264-010-1004-x

    Article  PubMed Central  PubMed  Google Scholar 

  7. Khan MA, Hossain FS, Ahmed I, Muthukumar N, Mohsen A (2013) Predictors of early mortality after hip fracture surgery. Int Orthop 37(11):2119–2124. doi:10.1007/s00264-013-2068-1

    Article  PubMed Central  PubMed  Google Scholar 

  8. Saracen A, Kotwica Z (2014) Treatment of multiple osteoporotic vertebral compression fractures by percutaneous cement augmentation. Int Orthop 38(11):2309–2312. doi:10.1007/s00264-014-2470-3

    Article  PubMed  Google Scholar 

  9. Rosa MA, Maccauro G, D’Arienzo M (1999) Bilateral acetabular fracture without trauma. Int Orthop 23(2):120–121

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Charlson M, Szatrowski TP, Peterson J, Gold J (1994) Validation of a combined comorbidity index. J Clin Epidemiol 47(11):1245–1251

    Article  CAS  PubMed  Google Scholar 

  11. American Society of Anesthesiologists. ASA Physical Status Classification System. Available at: http://asahq.org/resources/clinical-information/asa-physical-status-classification-system

  12. Letournel E (1980) Acetabulum fractures: classification and management. Clin Orthop Relat Res 151:81–106

    PubMed  Google Scholar 

  13. Bergstrom U, Bjornstig U, Stenlund H, Jonsson H, Svensson O (2008) Fracture mechanisms and fracture pattern in men and women aged 50 years and older: a study of a 12-year population-based injury register, Umea, Sweden. Osteoporos Int 19(9):1267–1273. doi:10.1007/s00198-007-0549-z

    Article  CAS  PubMed  Google Scholar 

  14. Chuang-Stein C, Tong DM (1995) Multiple comparisons procedures for comparing several treatments with a control based on binary data. Stat Med 14(23):2509–2522

    Article  CAS  PubMed  Google Scholar 

  15. Ferguson TA, Patel R, Bhandari M, Matta JM (2010) Fractures of the acetabulum in patients aged 60 years and older: an epidemiological and radiological study. J Bone Joint Surg Br 92(2):250–257. doi:10.1302/0301-620X.92B2.22488

    Article  CAS  PubMed  Google Scholar 

  16. Vanderschot P (2007) Treatment options of pelvic and acetabular fractures in patients with osteoporotic bone. Injury 38(4):497–508. doi:10.1016/j.injury.2007.01.021

    Article  CAS  PubMed  Google Scholar 

  17. Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E (2008) FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19(4):385–397. doi:10.1007/s00198-007-0543-5

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Brauer CA, Coca-Perraillon M, Cutler DM, Rosen AB (2009) Incidence and mortality of hip fractures in the United States. JAMA 302(14):1573–1579. doi:10.1001/jama.2009.1462

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Katz JN, Chang LC, Sangha O, Fossel AH, Bates DW (1996) Can comorbidity be measured by questionnaire rather than medical record review? Med Care 34(1):73–84

    Article  CAS  PubMed  Google Scholar 

  20. Poses RM, McClish DK, Smith WR, Bekes C, Scott WE (1996) Prediction of survival of critically ill patients by admission comorbidity. J Clin Epidemiol 49(7):743–747

    Article  CAS  PubMed  Google Scholar 

  21. Belmont PJ Jr, Garcia EJ, Romano D, Bader JO, Nelson KJ, Schoenfeld AJ (2014) Risk factors for complications and in-hospital mortality following hip fractures: a study using the National Trauma Data Bank. Arch Orthop Trauma Surg 134(5):597–604. doi:10.1007/s00402-014-1959-y

    Article  PubMed  Google Scholar 

  22. Frost SA, Nguyen ND, Black DA, Eisman JA, Nguyen TV (2011) Risk factors for in-hospital post-hip fracture mortality. Bone 49(3):553–558. doi:10.1016/j.bone.2011.06.002

    Article  PubMed  Google Scholar 

  23. Bible JE, Wegner A, McClure JM, Kadakia RJ, Richards JE, Bauer JM, Mir HR (2013) One-year mortality after acetabular fractures in elderly patients presenting to a level-one trauma center. J Orthop Trauma 28(3):154-159. doi:10.1097/BOT.0b013e31829e801b

    Article  Google Scholar 

  24. Ferguson TA, Patel R, Bhandari M, Matta JM (2010) Fractures of the acetabulum in patients aged 60 years and older: an epidemiological and radiological study. J Bone Joint Surg (Br) 92(2):250–257. doi:10.1302/0301-620X.92B2.22488

    Article  CAS  Google Scholar 

  25. Culemann U, Holstein JH, Kohler D, Tzioupis CC, Pizanis A, Tosounidis G, Burkhardt M, Pohlemann T (2010) Different stabilisation techniques for typical acetabular fractures in the elderly—a biomechanical assessment. Injury 41(4):405–410. doi:10.1016/j.injury.2009.12.001

    Article  CAS  PubMed  Google Scholar 

Download references

Conflicts of interest

The authors declare no conflict of interest in relation to the preparation of this paper.

Author information

Authors and Affiliations

  1. Haeundae Paik Hospital, Department of Orthopaedic Surgery, Inje University, Busan, Republic of Korea

    Ji Wan Kim

  2. Department of Orthopaedics, Denver Health Medical Center, University of Colorado, School of Medicine, 777 Bannock Street, Denver, CO, 80204, USA

    Benoit Herbert, Jiandong Hao & Cyril Mauffrey

  3. Department of Orthopaedic Surgery, The Hughston Clinic at Gwinnett Medical Center, Atlanta, Georgia, USA

    William Min & Bruce H. Ziran

Authors
  1. Ji Wan Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Benoit Herbert
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jiandong Hao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. William Min
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bruce H. Ziran
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Cyril Mauffrey
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cyril Mauffrey.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, J.W., Herbert, B., Hao, J. et al. Acetabular fractures in elderly patients: a comparative study of low-energy versus high-energy injuries. International Orthopaedics (SICOT) 39, 1175–1179 (2015). https://doi.org/10.1007/s00264-015-2711-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-015-2711-0

Keywords

Search

Navigation