Total hip replacement application in treatment of acetabular fractures in elderly patients

doi:10.3877/cma.j.issn.1674-134X.2023.03.013

Abstract

Abstract:

With the aging of the population, the number of elderly patients with acetabular fracture (AF) caused by low energy injury is increasing year by year, and there is no guideline or expert consensus on the treatment of AF in the elderly.The treatment of AF in the elderly can be divided into non-surgical treatment and surgical treatment.Non-surgical treatment is only suitable for patients who cannot tolerate surgery due to many bed complications and unsatisfactory expected results. Surgical treatment is recommended for elderly acetabular fractures. Different from open reduction and internal fixation (ORIF) as the gold standard for young acetabular fractures, ORIF should be carefully performed for elderly acetabular fractures because of the greater difficulty of surgical reduction and fixation and the higher incidence of complications such as traumatic arthritis and avascular necrosis of femoral head, require delay total hip replacement (THA) treatment. The effect of delayed THA is not as good as the primary THA, and delayed THA is difficult and risky.Acute THA (with or without ORIF), which can be used for hip reconstruction with one anesthesia and one operation, is increasingly being adopted as a new treatment option for AF in elderly patients with risk factors for adverse outcomes.In order to further clarify the application progress of THA in the treatment of elderly AF, the relevant literatures of THA on the indications, surgical difficulties and precautions of delayed THA and acute THA were reviewed and expounded in detail, so as to promote the optimal selection in the treatment of elderly AF.

Key words: Hip fractures, Aged, Arthroplasty, replacement, hip

Bo Wang, Ke Xu, Lin Liu, Binfei Zhang, Yan Zhuang, Peng Xu. Total hip replacement application in treatment of acetabular fractures in elderly patients[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(03): 385-390.

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