Clinical outcome of open reduction and internal fixation for acetabular fracture in the elderly

LI Yu-neng; SUN Xu; ZHU Shi-wen; WU Xin-bao; WANG Man-yi

doi:10.3969/j.issn.2095-252X.2017.03.004

Abstract：Objective To evaluate the clinical outcome of open reduction and internal fixation for acetabular fracture in the elderly.Methods From January 2011 to December 2012 a total of 26 elderly patients with mean age of 70.5 years ( range: 60 - 78 years ) who suffered acetabular fracture were included in this study. There were 15 male cases and 11 female cases. The fracture types were grouped according to Letournel-Judet classification, and all the patients were treated with open reduction and internal fixation in our hospital. Kocher-Langenbeck approach was employed for 16 cases, iliac inguinal approach for 8 cases and anterior- posterior approach for 2 cases respectively. The Merled'Aubigne & Postel scores, functional recovery scale ( FRS ) and Euro-Quality of 5 Dimension ( EQ-5D ) were applied to measure the clinical effect.Results All the surgeries were completed successfully and no patients died during hospitalization. The mean operation time was 165.5 min ( range: 90 - 330 min ), the mean intraoperative blood loss was 859 ml ( range: 550 - 2600 ml ) and the average hospital stay was 13.2 days ( range: 7 - 26 days ). All the patients were followed up for at least 2 years and the mean follow-up period was 27.2 months ( range: 24 - 37 months ). According to Merled'Aubigne & Postel scores the excellent and good rate was 76.2%. The FRS score was decreased from preoperative ( 92.6 ± 6.1 ) to postoperative ( 73.4 ± 12.7 ) (P < 0. 05 ), and the EQ-5D index was decreased from ( 0.91 ± 0.06 ) to ( 0.73 ± 0.12 ) (P < 0.05 ). At the last follow-up 61.5% of patients ( 16 / 26 ) could walk independently.Conclusions Open reduction and internal fixation can provide reliable clinical outcome for the elderly patient with acetabular fracture which contributes to early recovery of mobilization and life quality.