scholarly journals A Survey of High- and Low-Energy Acetabular Fractures in Elderly Patients

2019 ◽  
Vol 10 ◽  
pp. 215145931987042 ◽  
Author(s):  
Evgeny Dyskin ◽  
Brian W. Hill ◽  
Michael T. Torchia ◽  
Peter A. Cole
Keyword(s):  
Elderly Patients ◽  
Acetabular Fracture ◽  
Injury Severity ◽  
High Energy ◽  
Low Energy ◽  
Acetabular Fractures ◽  
Male Predominance ◽  
The Us ◽  
Initial Hospital ◽  
Comorbidity Index

Introduction: Geriatric patients represent 14% of acetabular fractures and are the fastest growing subset of patients affected by this injury in the US. Treatment outcomes have been reported as inferior to those achieved in younger patients after high-energy (HE) acetabular trauma. This study aimed to compare detailed demographic characteristics and clinical outcomes in elderly patients (≥65 years of age) treated in a tertiary North American trauma center for acetabular fractures after both high- and low-energy mechanisms of injury. Methods: Patients (≥65 years of age) diagnosed with an acetabular fracture were identified over a 7-year period. Patient and injury characteristics were extracted from our institutional trauma database. Length of stay, intervention, operative details, disposition, complications, readmissions, and mortality were analyzed. Results: One hundred nine patients were identified for inclusion. Low-energy mechanisms (simple falls) were found in 64 (58.7%) and HE mechanisms in 45 (41.3%) patients. The HE cohort was younger (74.6 vs 80.7 years; P < .001), had a higher male predominance (76% vs 56%; P = .10), a lower Charlson comorbidity index (1.29 ± 1.49 vs 2.16 ± 1.76; P = .01), and a higher injury severity score (19.90 ± 15.33 vs 6.46 ± 3.57; P < .001). Fracture patterns, described according to the Letournel-Judet classification, were similar between the 2 groups. Thirty-day mortality was significantly higher in the HE group (26.7% vs 3.1%; P < .001); however, the 1-year mortality rates were not statistically different (31.1% vs 25.0%; P = .20). Discussion: Patients with acetabular fractures sustained due to HE accidents demonstrate significantly higher 30-day mortality rate than patients with low-energy fractures, but similar mortality 1 year after the injury, despite having a much lower mean age and fewer comorbidities. Conclusion: Medical efforts made during initial hospital admission may have the biggest impact on survivorship following acetabular fracture.

scholarly journals Low energy fractures of the acetabulum

2014 ◽  
Vol 96 (4) ◽  
pp. 297-301 ◽  
Author(s):  
N Papadakos ◽  
R Pearce ◽  
MD Bircher
Keyword(s):  
Acetabular Fracture ◽  
High Energy ◽  
Fracture Pattern ◽  
Low Energy ◽  
Acetabular Fractures ◽  
Considerable Proportion ◽  
Female Ratio ◽  
Energy Mechanism ◽  
Pattern Distribution ◽  
Male To Female

Introduction Acetabular fractures due to high energy injuries are common and well documented; those secondary to low energy mechanisms are less well described. We undertook a retrospective study of the acetabular fracture referrals to our unit to evaluate the proportion of injuries resulting from a low energy mechanism. Methods A total of 573 acetabular fractures were evaluated from 1 January 2005 to 31 December 2008. The plain radiography and computed tomography of those sustaining a low energy fracture were assessed and the fracture patterns classified. Results Of the 573 acetabular fractures, 71 (12.4%) were recorded as being a result of a low energy mechanism. The male-to-female ratio was 2.4:1 and the mean patient age was 67.0 years (standard deviation: 19.1 years). There was a significantly higher number of fractures (p<0.001) involving the anterior column (with or without a posterior hemitransverse component) than in a number of previously conducted large acetabular fracture studies. Conclusions Our results demonstrate that low energy fractures make up a considerable proportion of acetabular fractures with a distinctly different fracture pattern distribution. With the continued predicted rise in the incidence of osteoporosis, life expectancy and an aging population, it is likely that this type of fracture will become increasingly more common, posing difficult management decisions and leading to procedures that are technically more challenging.

scholarly journals High- Versus Low-Energy Acetabular Fracture Outcomes in the Geriatric Population

2020 ◽  
Vol 11 ◽  
pp. 215145932093954 ◽  
Author(s):  
Alexa Cecil ◽  
Jonathan W. Yu ◽  
Viviana A. Rodriguez ◽  
Adam Sima ◽  
Jesse Torbert ◽  
...  
Keyword(s):  
Older Adults ◽  
Acetabular Fracture ◽  
Hip Dislocation ◽  
Posterior Wall ◽  
High Energy ◽  
Low Energy ◽  
Acetabular Fractures ◽  
Heterotopic Bone ◽  
Geriatric Population ◽  
Energy Group

Introduction: High-energy mechanisms of acetabular fracture in the geriatric population are becoming increasingly common as older adults remain active later in life. This study compared outcomes for high- versus low-energy acetabular fractures in older adults. Materials and Methods: We studied outcomes of 22 older adults with acetabular fracture who were treated at a level-I trauma center over a 4-year period. Fourteen patients were categorized as low-energy mechanism of injury, and 8 were identified as a high-energy mechanism. We analyzed patient demographics with univariate logistic regressions performed to assess differences in high- and low-energy group as well as patient characteristics compared with surgical outcomes. Results: Most high-energy mechanisms were caused by motor vehicle collision (n = 4, 50.0%), with most having posterior wall fractures (50.0%). Among patient characteristics, the mechanism of injury, hip dislocation, fracture types, and fracture gap had the largest differences between energy groups effect size (ES: 2.45, 1.43, 1.36, and 0.83, respectively). The high-energy group was more likely to require surgery (odds ratio [OR] = 2.80, 95% CI: 0.26-30.70), develop heterotopic bone (OR = 4.33, 95% CI: 0.33-57.65), develop arthritis (OR = 3.60, 95% CI: 0.45-28.56), and had longer time to surgery (mean = 4.8 days, standard deviation [SD] = 5.8 days) compared to low-energy group (mean = 2.5 days, SD = 2.3 days). Discussion: The results of this case series confirm previous findings that patients with high-energy acetabular fractures are predominantly male, younger, and have fewer comorbidities than those who sustained low-energy fractures. Our results demonstrate that the majority of the high-energy fracture patients also suffered a concurrent hip dislocation with posterior wall fracture and experienced a longer time to surgery than the low-energy group. Conclusion: Geriatric patients who sustained high-energy acetabular fractures tend to have higher overall rates of complications, including infection, traumatic arthritis, and heterotopic bone formation when compared with patients with a low-energy fracture mechanism.

Acetabular fractures in elderly patients: a comparative study of low-energy versus high-energy injuries

2015 ◽  
Vol 39 (6) ◽  
pp. 1175-1179 ◽  
Author(s):  
Ji Wan Kim ◽  
Benoit Herbert ◽  
Jiandong Hao ◽  
William Min ◽  
Bruce H. Ziran ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Comparative Study ◽  
High Energy ◽  
Low Energy ◽  
Acetabular Fractures

scholarly journals Discrimination of Low-Energy Acetabular Fractures from Controls Using Computed Tomography-Based Bone Characteristics

2020 ◽  
Vol 49 (1) ◽  
pp. 367-381
Author(s):  
Robel K. Gebre ◽  
Jukka Hirvasniemi ◽  
Iikka Lantto ◽  
Simo Saarakkala ◽  
Juhana Leppilahti ◽  
...  
Keyword(s):  
Machine Learning ◽  
Risk Factors ◽  
Computed Tomography ◽  
Femoral Head ◽  
Acetabular Fracture ◽  
Ct Images ◽  
Low Energy ◽  
Acetabular Fractures ◽  
Operating Characteristics ◽  
Femoral Neck Axis

AbstractThe incidence of low-energy acetabular fractures has increased. However, the structural factors for these fractures remain unclear. The objective of this study was to extract trabecular bone architecture and proximal femur geometry (PFG) measures from clinical computed tomography (CT) images to (1) identify possible structural risk factors of acetabular fractures, and (2) to discriminate fracture cases from controls using machine learning methods. CT images of 107 acetabular fracture subjects (25 females, 82 males) and 107 age-gender matched controls were examined. Three volumes of interest, one at the acetabulum and two at the femoral head, were extracted to calculate bone volume fraction (BV/TV), gray-level co-occurrence matrix and histogram of the gray values (GV). The PFG was defined by neck shaft angle and femoral neck axis length. Relationships between the variables were assessed by statistical mean comparisons and correlation analyses. Bayesian logistic regression and Elastic net machine learning models were implemented for classification. We found lower BV/TV at the femoral head (0.51 vs. 0.55, p = 0.012) and lower mean GV at both the acetabulum (98.81 vs. 115.33, p < 0.001) and femoral head (150.63 vs. 163.47, p = 0.005) of fracture subjects when compared to their matched controls. The trabeculae within the femoral heads of the acetabular fracture sides differed in structure, density and texture from the corresponding control sides of the fracture subjects. Moreover, the PFG and trabecular architectural variables, alone and in combination, were able to discriminate fracture cases from controls (area under the receiver operating characteristics curve 0.70 to 0.79). In conclusion, lower density in the acetabulum and femoral head with abnormal trabecular structure and texture at the femoral head, appear to be risk factors for low-energy acetabular fractures.

Displaced Acetabular Fracture in Elderly Patients: Is Acute Arthroplasty an Effective Option?

2019 ◽  
Vol 157 (06) ◽  
pp. 676-683 ◽  
Author(s):  
Zhengming Yang ◽  
Stephan Maximillian Röhrl ◽  
Lars Nordsletten
Keyword(s):  
Systematic Review ◽  
Elderly Patients ◽  
Acetabular Fracture ◽  
Treatment Options ◽  
Treatment Recommendation ◽  
Acetabular Fractures ◽  
Review Of The Literature ◽  
Effective Treatment Option ◽  
Elderly Individuals ◽  
Effective Option

Abstract Background and study aim Elderly individuals are the most rapidly growing subgroup of patients currently sustaining acetabular fractures, and total hip arthroplasty (THA) is being applied more and more in the treatment of acetabular fractures. The purpose of this study was to review the available literature regarding displaced acetabular fractures in elderly patients treated with acute THA. Study design A search was conducted using the electronic databases Medline, PubMed, ISI Web of Knowledge, and Scopus on papers published between January 1960 and November 2018 using the terms “acetabular fracture” plus “elderly patients” plus “arthroplasty”. A systematic review of the literature on the different treatment options for acute THA is presented. Results The search yielded a total of 320 articles, and 9 articles were selected for review. The indications, techniques, approaches, and complications of THA are discussed, and a treatment recommendation based on the selected articles is given. Conclusion We consider acute arthroplasty an effective treatment option for displaced acetabular fractures in elderly patients, while different techniques should be used for different displaced acetabular fractures in this patient group.

scholarly journals Literature Review and Clinical Presentation of Bilateral Acetabular Fractures Secondary to Seizure Attacks

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Alexandre H. Nehme ◽  
Jihad F. Matta ◽  
Alaa G. Boughannam ◽  
Fouad C. Jabbour ◽  
Joseph Imad ◽  
...  
Keyword(s):  
Acetabular Fracture ◽  
Clinical Presentation ◽  
Delayed Diagnosis ◽  
High Energy ◽  
Fracture Dislocation ◽  
Acetabular Fractures ◽  
Seizure Attack ◽  
Direct Trauma ◽  
External Trauma ◽  
Seizure Attacks

Central acetabular fracture dislocation is usually caused by high-energy external trauma. However, 26 cases that occurred as a result of a seizure attack appeared in the literature from 1970 to 2007, with the seizure attacks themselves caused by many different factors. In this setting, the central acetabular fracture not caused by direct trauma might initially remain unnoticed leading to a delayed diagnosis. In some cases, this may lead to death as a result of massive blood loss. We here present a case of bilateral central acetabular fracture dislocation as a result of a seizure attack.

The Treatment of Acetabular Fracture Complications in a Combination of Post-traumatic Hip Joint Osteoarthritis and Femoral Fracture for Polytrauma Patient

2011 ◽  
Vol 11 (1) ◽  
pp. 164-166
Author(s):  
Andris Vikmanis ◽  
Andris Jumtins
Keyword(s):  
Hip Joint ◽  
Femoral Fracture ◽  
Acetabular Fracture ◽  
Bone Fractures ◽  
High Energy ◽  
Pelvic Bone ◽  
Acetabular Fractures ◽  
Post Traumatic ◽  
Polytrauma Patients ◽  
Polytrauma Patient

The Treatment of Acetabular Fracture Complications in a Combination of Post-traumatic Hip Joint Osteoarthritis and Femoral Fracture for Polytrauma PatientPelvic bone fractures are related to a high energy injury. Therefore with an increase of the traffic intensity simultaneously grows the number of polytrauma patients, who have pelvic bone fractures of various severity levels. In the case of acetabular fractures, as the most frequent complication is the hip joint post-traumatic degeneratively destructive osteoarthritis, in whose treatment very often the hip joint arthroplasty is necessary. The frequency of this complication is affected by the precision of repositioning and the strength of fixation of an acetabular fracture.

Low energy vs. high energy depositional settings and related sedimentary bodies in early Senenian rudist bearing carbonate shelves (central-southern Italy)

2001 ◽  
Vol 28 (1) ◽  
pp. 37-40 ◽  
Author(s):  
Gabriele Carannante ◽  
A. Laviano ◽  
D. Ruberti ◽  
Lucia Simone ◽  
G. Sirna ◽  
...  
Keyword(s):  
Southern Italy ◽  
High Energy ◽  
Low Energy ◽  
Depositional Settings

Transportation: Fuel Energies

2017 ◽  
Author(s):  
Peter Rez
Keyword(s):  
Energy Density ◽  
Fossil Fuels ◽  
High Energy ◽  
Ease Of Use ◽  
Low Energy ◽  
High Energy Density ◽  
Nuclear Fuels ◽  
Liquid Hydrocarbons ◽  
Transportation Fuel ◽  
Journey Time

Transportation efficiency can be measured in terms of the energy needed to move a person or a tonne of freight over a given distance. For passengers, journey time is important, so an equally useful measure is the product of the energy used and the time taken for the journey. Transportation requires storage of energy. Rechargeable systems such as batteries have very low energy densities as compared to fossil fuels. The highest energy densities come from nuclear fuels, although, because of shielding requirements, these are not practical for most forms of transportation. Liquid hydrocarbons represent a nice compromise between high energy density and ease of use.

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