Geriatric Acetabular Fractures and Mortality

The geriatric population is a rapidly growing segment of society with longer life expectancies and more active lifestyles than previous generations. More and more geriatric patients are being seen with acetabular fractures, which can have a significant impact on the remainder of an elderly patient’s life.

In the April issue of JOT, Gary et al publish their results from 3 centers in “Effect of Surgical Treatment on Mortality After Acetabular Fracture in the Elderly: A Multicenter Study of 454 Patients.”  The authors conclude that the operative treatment of acetabular fractures does not increase or decrease mortality, once comorbidities are taken into account, and that the decision for operative versus nonoperative treatment of geriatric
acetabular fractures should not be justified based on the concern for increased or decreased mortality alone.  Also of note, the overall one-year mortality for geriatric acetabular fractures was 16%, which is lower than that for elderly patients with proximal femur fractures.

These findings are in line with previous studies, including a single center study by Bible et al (JOT March 2014) that found the 1-year mortality rates for elderly patients with isolated acetabular fractures are significantly lower than those reported previously for hip fractures and acetabular fractures with concurrent injuries.  The authors also found no significant differences in mortality rates between operative and nonoperative patients across all time points.

Please check out article by Gary et al in the April issue of JOT, and share your comments on the treatment of geriatric acetabular fractures.

Hassan R. Mir, MD, MBA, FACS

Editor | OsteoSynthesis – The JOT Online Discussion Forum

One thought on “Geriatric Acetabular Fractures and Mortality

  1. The results definitely surprised us a little bit with this retrospective study. One thing we found is that these injuries are very different from elder hip fractures with a lower one-year mortality and the finding that surgical intervention had no impact on mortality once patients were medical condition was taken into account.
    I personally have used each of the four treatments in the past year and believe individualizing that decision to each patient and fracture pattern is important. I have also trended towards early mobilization and nonoperative treatment for osteoporotic fractures without a posterior dislocation. Avoiding a bedridden patient is the most important part of the treatment decision in my mind.

    Liked by 1 person

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