Pelvis/acetabulum: management of geriatric injuries

Abstract. Geriatric pelvic and acetabular fractures pose significant challenges due to patient frailty, comorbidities, and the complexity of fracture patterns. This review examines current evidence and evolving strategies for managing these injuries. Treatment approaches range from nonoperative mana...

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Main Authors: Jaime A. Leal, MD, MHPE, Pol M. Rommens, MD, PhD, Rafael Amadei, MD, FIOTA
Format: Article
Language:English
Published: Wolters Kluwer 2025-05-01
Series:OTA International
Online Access:http://journals.lww.com/10.1097/OI9.0000000000000394
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author Jaime A. Leal, MD, MHPE
Pol M. Rommens, MD, PhD
Rafael Amadei, MD, FIOTA
author_facet Jaime A. Leal, MD, MHPE
Pol M. Rommens, MD, PhD
Rafael Amadei, MD, FIOTA
author_sort Jaime A. Leal, MD, MHPE
collection DOAJ
description Abstract. Geriatric pelvic and acetabular fractures pose significant challenges due to patient frailty, comorbidities, and the complexity of fracture patterns. This review examines current evidence and evolving strategies for managing these injuries. Treatment approaches range from nonoperative management to surgical interventions, including percutaneous fixation, open reduction and internal fixation (ORIF), and total hip arthroplasty, either as a standalone procedure or combined with ORIF. Decision making is guided by fracture morphology, patient functionality, and physiological reserve to optimize clinical outcomes. Minimally invasive techniques, particularly for fragility fractures of the pelvis, have gained traction because of their ability to provide stable fixation while minimizing surgical morbidity. The importance of early mobilization and a multidisciplinary perioperative approach is highlighted as essential in reducing complications and improving recovery. Despite advancements, controversy remains regarding the optimal treatment of complex acetabular fractures in elderly patients. This review synthesizes the latest evidence and expert perspectives to aid clinicians in selecting the most appropriate management strategies, with the goal of restoring mobility, minimizing complications, and enhancing the quality of life in this vulnerable population.
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spelling doaj-art-ef1daaf6c60b47baa987cc04a0012af02025-08-20T02:29:12ZengWolters KluwerOTA International2574-21672025-05-0183S10.1097/OI9.0000000000000394OI90000000000000394Pelvis/acetabulum: management of geriatric injuriesJaime A. Leal, MD, MHPE0Pol M. Rommens, MD, PhD1Rafael Amadei, MD, FIOTA2a Department of Orthopaedics and Traumatology, Hospital Universitario de La Samaritana, Bogotá, Colombiab Department of Orthopedics and Traumatology, University Medical Centre Mainz, Johannes Gutenberg-University, Mainz, Germanyc Cuenca Alta Cañuelas Hospital, Buenos Aires, Argentina.Abstract. Geriatric pelvic and acetabular fractures pose significant challenges due to patient frailty, comorbidities, and the complexity of fracture patterns. This review examines current evidence and evolving strategies for managing these injuries. Treatment approaches range from nonoperative management to surgical interventions, including percutaneous fixation, open reduction and internal fixation (ORIF), and total hip arthroplasty, either as a standalone procedure or combined with ORIF. Decision making is guided by fracture morphology, patient functionality, and physiological reserve to optimize clinical outcomes. Minimally invasive techniques, particularly for fragility fractures of the pelvis, have gained traction because of their ability to provide stable fixation while minimizing surgical morbidity. The importance of early mobilization and a multidisciplinary perioperative approach is highlighted as essential in reducing complications and improving recovery. Despite advancements, controversy remains regarding the optimal treatment of complex acetabular fractures in elderly patients. This review synthesizes the latest evidence and expert perspectives to aid clinicians in selecting the most appropriate management strategies, with the goal of restoring mobility, minimizing complications, and enhancing the quality of life in this vulnerable population.http://journals.lww.com/10.1097/OI9.0000000000000394
spellingShingle Jaime A. Leal, MD, MHPE
Pol M. Rommens, MD, PhD
Rafael Amadei, MD, FIOTA
Pelvis/acetabulum: management of geriatric injuries
OTA International
title Pelvis/acetabulum: management of geriatric injuries
title_full Pelvis/acetabulum: management of geriatric injuries
title_fullStr Pelvis/acetabulum: management of geriatric injuries
title_full_unstemmed Pelvis/acetabulum: management of geriatric injuries
title_short Pelvis/acetabulum: management of geriatric injuries
title_sort pelvis acetabulum management of geriatric injuries
url http://journals.lww.com/10.1097/OI9.0000000000000394
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