Functional Outcomes of Elderly Patients With Nonoperatively Treated Acetabular Fractures That Meet Operative Criteria

J Orthop Trauma. 2017 Dec;31(12):644-649. doi: 10.1097/BOT.0000000000000990.

Abstract

Objectives: To report functional outcomes of displaced acetabular fractures treated nonoperatively in the geriatric patient population.

Design: Retrospective case series.

Setting: Two Level I trauma centers.

Patients: Twenty-seven patients 60 years of age or older who sustained displaced acetabular fractures during an 11-year period.

Intervention: Nonoperative treatment.

Main outcome measurements: Primary outcome measurements were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and Short Form 8 (SF-8) scores. Secondary outcome measurements were conversion to open reduction and internal fixation or total hip arthroplasty and 1-year mortality.

Results: Twenty-six patients completed the WOMAC and SF-8 surveys. The overall WOMAC score was 12.9 ± 15.6 (range, 0-59.4). The average physical SF-8 was 51.1 ± 8.7 (range, 30.4-58.6), and the average mental SF-8 was 55 ± 6.2 (range, 30.4-58.6). The 1-year mortality rate was 24%. Conversion of treatment occurred in 15% of patients.

Conclusions: Elderly patients with fracture patterns that would qualify for operative treatment in younger healthy patients had surprisingly good outcome scores when treated nonoperatively.

Level of evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Publication types

  • Multicenter Study

MeSH terms

  • Acetabulum / diagnostic imaging
  • Acetabulum / injuries*
  • Aged
  • Aged, 80 and over
  • Conservative Treatment / methods*
  • Female
  • Fracture Fixation, Internal
  • Hip Fractures / diagnosis
  • Hip Fractures / physiopathology
  • Hip Fractures / therapy*
  • Humans
  • Male
  • Middle Aged
  • Motor Activity / physiology*
  • Radiography
  • Range of Motion, Articular / physiology*
  • Retrospective Studies
  • Trauma Centers*
  • Treatment Outcome