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ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2012, Number 3

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Acta Ortop Mex 2012; 26 (3)

Trabecular metal box for acute acetabular fracture in an elderly patient

Chana-Rodríguez F, Villanueva-Martínez M, Rojo-Manaute JM, Ortiz-Espada A, De las Heras Sánchez-Heredero J, Vaquero-Martín J

Language: Spanish
References: 21
Page: 185-188
PDF size: 74.79 Kb.


ABSTRACT

Background: We are currently observing an increase in the incidence of acetabular fractures in elderly patients due to the increase in this population age group. These fractures represent a challenge to the traumatologist because in some cases there is the surgical alternative of combining fixation with total acute hip arthroplasty. In this paper we explore the use of trabecular metal combining the stability provided by a cage with potential bone incorporation, applying the principles of revision surgery to speed-up the healing process without the limitations resulting from the restrictions in the load of the operated limb. Material and methods: We assessed the clinical and radiological results, with a 2-year follow-up, after total hip arthroplasty for the acute treatment of an acetabular fracture of the anterior column, with involvement of the quadrilateral lamina in an elderly 85 year-old patient. Results: Important pain relief occurred, with functional improvement and an appropriate range of motion using the Merle d’Aubigné system. Radiologically, the graft areas in the particles surrounding the acetabular component were uniformly integrated. No loosening, screw rupture or implant migration occurred. Conclusions: This indication using a revision technique based on a trabecular metal reconstruction cage should be considered as an alternative to bear in mind in these patients.


REFERENCES

  1. Campbell AJ, Borrie MJ, Spears GF, et al: Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. Age Ageing 1990; 19: 136-41.

  2. Kannus P, Palvanen M, Niemi S, et al: Epidemiology of osteoporotic pelvic fractures in elderly people in Finland: sharp increase in 1970-1997 and alarming projections for the new millennium. Osteoporosis Int 2000; 11: 443-8.

  3. Lonner JH, Koval KJ: Polytrauma in the elderly. Clin Orthop 1995; 318: 136-43.

  4. Mears DC, Velyvis JH, Chang CP: Displaced acetabular fractures managed operatively: indicators of outcome. Clin Orthop Relat Res 2003; (407): 173-86.

  5. Pagenkopf E, Grosse A, Partal G, Helfet DL: Acetabular fractures in the elderly: treatment recommendations. HSS J 2006; 2: 161-71.

  6. Holm CL: Treatment of pelvic fractures and dislocations. Skeletal traction and the dual pelvic traction sling. Clin Orthop Relat Res 1973; (97): 97-107.

  7. Judet R, Judet J, Letournel E: Fractures of the acetabulum: classification and surgical approaches for open reduction. Preliminary report. J Bone Joint Surg Am 1964; 46: 1615-46.

  8. Matta JM, Merritt PO: Displaced acetabular fractures. Clin Orthop Relat Res 1988; (230): 83-97.

  9. Mears DC: Surgical treatment of acetabular fractures in elderly patients with osteoporotic bone. J Am Acad Orthop Surg 1999; 7(2): 128-41.

  10. Saklad M: Grading of patients for surgical procedures. Anesthesiology 1941; 2: 281-4.

  11. Letournel E: Acetabulum fractures: classification and management. Clin Orthop Relat Res 1980; (151): 81-106.

  12. Ovre S, et al: Modification of the Harris Hip Score in acetabular fracture treatment. Injury 2007; 38(3): 344-9.

  13. Berry DJ: Total hip arthroplasty following acetabular fracture. Orthopedics 1999; 22: 837-9.

  14. Hepple S, Ward AJ. Early outcome of acute total hip arthroplasty fo­llowing acetabular fracture. J Bone Joint Surg [Br] 2003; 85-B(Suppl 2): 98.

  15. Ilyas, Rabbani: Total hip arthroplasty in chronic unreduced hip fracture-dislocation. J Arthroplasty 2009; 24(6): 903-8.

  16. Jiménez ML, Tile M, Schenk RS:. Total hip replacement after acetabular fracture. Orthop Clin North Am 1997; 28: 435-46.

  17. Romness DW, Lewallen DG: Total hip arthroplasty after fracture of the acetabulum. Long-term results. J Bone Joint Surg Br 1990; 72: 761-4.

  18. Peters CL, Miller M, Erickson J, Hall P, Samuelson K: Acetabular revision with a modular anti-protrusio acetabular component. J Arthroplasty 2004; 19: 67-72.

  19. Sporer, Paprosky: Acetabular revision using a trabecular metal acetabular component for severe acetabular bone loss associated with a pelvic discontinuity. J Arthroplasty 2006; 21(6 Suppl 2): 87-90.

  20. Van Kleunen, et al: Acetabular revisions using trabecular metal cups and augments. J Arthroplasty 2009; 24(6 Suppl): 64-8.

  21. Weeden SH, Schmidt RH: The use of tantalum porous metal implants for Paprosky 3A and 3B defects. J Arthroplasty 2007; 22(6 Suppl. 2): 151-5.




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