Treatment of Geriatric Acetabular Fractures Using the Modified Stoppa Approach: A Review Article of Technique, Tips, and Pitfalls.

The surgical treatment of geriatric acetabular fractures is becoming increasingly important due to a demographic change in age. While acetabular fractures used to occur more frequently in younger patients, they are currently more prevalent in geriatric patients. This change has also led to an increase in the frequency of anterior and combined anterior acetabular fractures.

[Periprosthetic acetabular fractures: classifications, treatment and challenges].

Periprosthetic acetabular fractures (PPAF) are fractures of the acetabulum with a hip endoprosthesis in place. They are a rare complication, although they are occurring more frequently due to the increase in patients being fitted with total hip arthroplasty (THA) and the long service life of the implants. At present, only a small amount of scientific literature exists, particularly regarding the surgical treatment of these fracture types.

[Osteosynthesis of geriatric acetabular fractures].

The aim of the treatment of acetabular fractures is principally an anatomical reconstruction of the joint surface to avoid posttraumatic arthritis. The increasing number of geriatric patients with acetabular fractures of the anterior column type resulting from simple falls on the side and substantial patient-related inherited comorbidities, represent particular challenges for the surgical approach and osteosynthesis due to the osteoporotic bone quality. Due to the establishment of minimally invasive lateral pelvic accesses to the acetabulum and the adaptation of the osteosynthesis technique and material to these approaches, it appears that even in very old patients with acetabular fractures mobility can be better and more rapidly restored and sequelae caused by immobility can be prevented.

[What constitutes a good osteosynthesis?].

What constitutes a "good osteosynthesis"? Although the question seems trivial, on closer inspection there are manifold influencing factors that affect fracture healing, so that this question is ultimately not that easy to answer. The first steps are already set with taking the patient history and initial diagnostics. An adequate analysis of the fracture with a coherent preoperative concept for stabilization based on the latest scientific findings and a subsequent adequate implementation of the planning in the operating room make the success of an osteosynthesis and thus a "good osteosynthesis".

[Influence of the pelvic trauma registry of the DGU on treatment of pelvic ring fractures].

Fractures of the pelvic ring are comparatively rare with an incidence of 2-8 % of all fractures depending on the study in question. The severity of pelvic ring fractures can be very different ranging from simple and mostly "harmless" type A fractures up to life-threatening complex type C fractures. Although it was previously postulated that high-energy trauma was necessary to induce a pelvic ring fracture, over the past decades it became more and more evident, not least from data in the pelvic trauma registry of the German Society for Trauma Surgery (DGU), that low-energy minor trauma can also cause pelvic ring fractures of osteoporotic bone and in a rapidly increasing population of geriatric patients insufficiency fractures of the pelvic ring are nowadays observed with no preceding trauma.