Prótesis de cadera como tratamiento de las fracturas acetabulares en el adulto mayor.

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Bibliographic Details
Title:	Prótesis de cadera como tratamiento de las fracturas acetabulares en el adulto mayor.
Alternate Title:	Hip prostheses as a treatment for acetabular fractures in the elderly.
Authors:	B., Capurro-Soler^1,2,3, M., Gidi¹, P., Serrano¹, W., Pizarro-Geraldo², S., González-von der Meden² dr.sebastiangvdm@gmail.com, M., Tey¹, A., León¹, F., Marqués¹
Source:	Acta Ortopédica Mexicana. May/Jun2025, Vol. 39 Issue 3, p128-134. 7p.
Subjects:	HIP fractures, TOTAL hip replacement, OLDER people, FEMUR head, SURGICAL complications, ACETABULUM surgery
Abstract (English):	Introduction: low-energy acetabular fractures in older adults have significantly increased, with an incidence up to 2.4 times higher over the last three decades. While osteosynthesis is the standard treatment in young patients, its suitability for older adults is debated due to higher risks of complications and reinterventions. These risks are exacerbated by osteoporosis, comminution, and articular surface damage, such as femoral head impaction and preexisting conditions like coxarthrosis. The literature suggests that total hip arthroplasty (THA) may be more appropriate in cases of severe displacement, articular comminution, acetabular impaction in the load zone, and other complex scenarios. Material and methods: this retrospective study analyzed patients over 65 years with acetabular fractures treated with THA between 2008 and 2018, with a minimum follow-up of one year. Parameters evaluated included fracture type, mechanism of injury, associated injuries, use of traction, time to surgery, type of implant, and complications. Clinical evaluations utilized the Merle d'Aubigné-Postel (MAP) scale, and statistical analysis was conducted using SPSS 18.0. Results: seven patients were included, with a mean age of 76.4 years. The most common fracture was anterior column with associated posterior hemi-transverse. The most used implant was the uncemented tantalum revision acetabulum. The mean follow-up period was 7.8 years, with an average MAP score of 16.6 at one year. No intraoperative complications occurred, and radiographic consolidation was observed in all cases at three months. Conclusions: THA showed good clinical outcomes in older adults with acetabular fractures, without increasing the risk of complications, and demonstrated high long-term survival. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	Introducción: las fracturas acetabulares de baja energía en adultos mayores han aumentado significativamente, con una incidencia hasta 2.4 veces más alta en las últimas tres décadas. Aunque la osteosíntesis es el tratamiento estándar en pacientes jóvenes, su idoneidad en adultos mayores es debatida debido a un mayor riesgo de complicaciones y reintervenciones. Estos riesgos se ven agravados por la osteoporosis, la conminución y el daño en la superficie articular, como la impactación de la cabeza femoral y condiciones preexistentes como la coxartrosis. La literatura sugiere que la prótesis total de cadera (PTC) puede ser más adecuada en casos de desplazamiento grave, conminución articular, impactación acetabular en la zona de carga y otros escenarios complejos. Material y métodos: este estudio retrospectivo analizó pacientes mayores de 65 años con fracturas de acetábulo tratados con PTC entre 2008 y 2018, con un seguimiento mínimo de un año. Se evaluaron el tipo de fractura, el mecanismo de lesión, las lesiones asociadas, el uso de tracción, el tiempo hasta la cirugía, el tipo de implante y las complicaciones. Las evaluaciones clínicas usaron la escala de Merle d'Aubigné-Postel (MAP) y el análisis estadístico se realizó con SPSS 18.0. Resultados: se incluyeron siete pacientes con edad media de 76.4 años. La fractura más común fue de columna anterior con hemitransversa posterior asociada. El implante más utilizado fue el acetábulo de revisión de tantalio no cementado. El seguimiento medio fue de 7.8 años, con un puntaje MAP promedio de 16.6 al año. No ocurrieron complicaciones intraoperatorias y se observó consolidación radiográfica en todos los casos a los tres meses. Conclusiones: la PTC mostró buenos resultados clínicos en adultos mayores con fracturas acetabulares, sin aumentar el riesgo de complicaciones y con una alta supervivencia a largo plazo. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	Introduction: low-energy acetabular fractures in older adults have significantly increased, with an incidence up to 2.4 times higher over the last three decades. While osteosynthesis is the standard treatment in young patients, its suitability for older adults is debated due to higher risks of complications and reinterventions. These risks are exacerbated by osteoporosis, comminution, and articular surface damage, such as femoral head impaction and preexisting conditions like coxarthrosis. The literature suggests that total hip arthroplasty (THA) may be more appropriate in cases of severe displacement, articular comminution, acetabular impaction in the load zone, and other complex scenarios. Material and methods: this retrospective study analyzed patients over 65 years with acetabular fractures treated with THA between 2008 and 2018, with a minimum follow-up of one year. Parameters evaluated included fracture type, mechanism of injury, associated injuries, use of traction, time to surgery, type of implant, and complications. Clinical evaluations utilized the Merle d'Aubigné-Postel (MAP) scale, and statistical analysis was conducted using SPSS 18.0. Results: seven patients were included, with a mean age of 76.4 years. The most common fracture was anterior column with associated posterior hemi-transverse. The most used implant was the uncemented tantalum revision acetabulum. The mean follow-up period was 7.8 years, with an average MAP score of 16.6 at one year. No intraoperative complications occurred, and radiographic consolidation was observed in all cases at three months. Conclusions: THA showed good clinical outcomes in older adults with acetabular fractures, without increasing the risk of complications, and demonstrated high long-term survival. [ABSTRACT FROM AUTHOR]
ISSN:	23064102
DOI:	10.35366/119906