Individualized Plan of Care for the Geriatric Patient With Acetabular Fracture

Elderly adults currently represent the most rapidly growing segment of the patient population. As the number of geriatric patients increases, the incidence of acetabular fractures in this population can be expected to increase as well. Optimal management of these injuries is controversial. Patient factors, such as preinjury functional level, medical comorbidities, and poor bone quality, can confound the treatment plan, as can injury characteristics, such as fracture pattern and articular damage. Although open reduction and internal fixation has been advocated as the gold standard for any displaced acetabular fracture, in the elderly patient alternatives, including percutaneous fixation and total hip arthroplasty, either acute or delayed, should be considered. Exact indications for each of these options are often unclear. Although it is helpful to follow a logical algorithm in determining the best management for the geriatric acetabular fracture, the importance of individualizing treatment cannot be overemphasized.