Percutaneous screw fixation of acetabular fractures in elderly patients

Purpose of review: Older patients frequently have co-morbid conditions that complicate the lengthy surgery involved with open reduction and internal fixation of displaced acetabular fractures. Percutaneous stabilization of acetabular fractures in this patient population may be beneficial. Recent findings: In a review of our first 18 patients with displaced acetabular fractures treated with percutaneous techniques, our outcomes were roughly equivalent to the more traditional techniques using open reduction and internal fixation or open reduction with immediate total hip arthroplasty. The percutaneous technique has the added benefits of less blood loss, shorter operating time and less perioperative complications. Furthermore, if total hip replacement becomes necessary, the percutaneous technique allows for later hip arthroplasty through virgin tissue. Summary: Our current opinion is that these benefits, and the functional results obtained, make limited open reduction and percutaneous screw fixation of acetabular fractures a viable treatment option for elderly patients with acetabular fractures.