National Centre for Pelvic & Acetabular Surgery, Department of Trauma & Orthopaedics, Tallaght University Hospital, Dublin, D24NROA, Ireland.
Ir J Med Sci. 2022 Jun;191(3):1223-1228. doi: 10.1007/s11845-021-02711-2. Epub 2021 Jul 19.
The incidence of acetabular fractures in the elderly population is ever increasing. While management of acetabular fractures in young patients following high-energy trauma is well described, treatment of the elderly patient subgroup is complex and requires a unique, individualized approach. A variety of treatment strategies including operative and non-operative approaches exists to manage this vulnerable patient group. Conservative management of acetabular fractures in the elderly continues to play an important role in treatment of both stable fracture patterns and those medically unfit for surgery. AIM : This review assessing the current literature was undertaken with the purpose of summarising the challenges of management in this at-risk cohort as well as quantifying the role and outcomes following conservative management in the elderly. CONCLUSION: Our recommendation is that conservative management of acetabular fractures in the elderly can be considered as a treatment option on a case-by-case basis accounting for patient, injury, and surgical factors. If it is to be pursued, we advise a multidisciplinary approach focused on early mobility, minimisation of risk and regular follow-up to optimise patient outcomes.
老年人群中髋臼骨折的发病率不断增加。虽然高能量创伤后年轻患者髋臼骨折的治疗已有明确描述，但老年患者亚组的治疗较为复杂，需要采用独特的个体化方法。存在多种治疗策略，包括手术和非手术方法，可用于治疗这群脆弱的患者。对于老年髋臼骨折患者，保守治疗在稳定骨折模式和不适合手术的患者的治疗中仍然发挥着重要作用。目的：本次评估当前文献的综述旨在总结该高危人群管理方面的挑战，并量化保守治疗在老年患者中的作用和结果。结论：我们的建议是，应根据患者、损伤和手术因素，逐个病例考虑对老年髋臼骨折患者进行保守治疗。如果要进行保守治疗，我们建议采用多学科方法，重点是早期活动、降低风险和定期随访，以优化患者的治疗效果。
