Internal fixation of acetabular quadrilateral plate fractures in elderly patients: Could the fracture reduction quality affect their functional recovery?

Background Osteoporotic acetabular fractures frequently involve the quadrilateral plate (QP), a flat and thin bone constituting the medial wall of the acetabulum. This study aims to assess the impact of the quality of osteoporotic QP fractures reduction on the patients’ functional recovery, at 24 mo...

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Published in:Aging clinical and experimental research 2021-06, Vol.33 (6), p.1627-1633
Main Authors: Panella, Antonello, Solarino, Giuseppe, Vicenti, Giovanni, Bizzoca, Davide, Baglioni, Marco, Fortunato, Francesco, Maruccia, Francesco, Notarnicola, Angela, Piazzolla, Andrea, Pascarella, Raffaele, Belluati, Alberto, Moretti, Biagio
Format: Article
Language:English
Subjects:
Fractures
Geriatrics/Gerontology
Hip joint
Medicine
Medicine & Public Health
Original
Original Article
Trauma
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Summary:Background Osteoporotic acetabular fractures frequently involve the quadrilateral plate (QP), a flat and thin bone constituting the medial wall of the acetabulum. This study aims to assess the impact of the quality of osteoporotic QP fractures reduction on the patients’ functional recovery, at 24 months follow-up. Methods Patients referring with osteoporotic QP fractures to our Level I trauma centre were prospectively recruited. Inclusion criteria: patients aged 60 years old or older; osteoporosis, defined as Dual-energy X-ray Absorptiometry (DXA) T-score ≤ − 2.5; acute acetabular fracture; anatomic or good fracture reduction according to Matta on postoperative CT. Exclusion criteria: moderate cognitive impairment (defined as Mini-Mental State Examination  3 mm) on postoperative CT. Based on this classification: patients with a poor fracture reduction were excluded from this study, patients with an anatomical reduction were recruited in Group-A and patients with a good reduction in Group-B. All the patients underwent a clinical and radiographic 24-months follow-up. Results 68 patients (males 38; females 30; mean age 68.6 years old; range 60–79) were finally included in in the study. No cases of open fractures or concomitant pelvic ring fractures were observed. Based on the post-operative CT, 39 patients showed an anatomic fracture reduction (Group-A) while the remaining 29 patients revealed a good fracture reduction (Group-B). Complication rates and mean clinical scores showed no significant differences between groups, at 24-months follow-up. Conclusions In this study, the functional recovery at 24 months follow-up showed no significant differences in elderly patients with QP fracture undergoing anatomical reconstruction (displacement 0–1 mm) compared to patients receiving a good QP fracture reconstruction (displacement ≤ 3 mm).
ISSN:1720-8319
1594-0667
1720-8319
DOI:10.1007/s40520-020-01682-1