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Introduction <p>The occurrence of associated both-column acetabular fractures (ABC-AFs) is common in the elderly, yet their morphological characteristics compared to younger adults remain unclear.</p> Materials and methods <p>This retrospective study analyzed 123 cases of ABC-AFs: elderly patients (≥ 65 years, <i>n</i> = 47, group A) and younger adults (&lt; 65 years, <i>n</i> = 76, group B). Using Mimics and 3-matic, fracture line (FL) distributions in the anterior column (AC), quadrilateral plate (QP), and posterior wall (PW) fragments were examined. Comparisons focused on the articular surface, ilium, QP area, and retro-acetabular surface (RAS). Harris hip scores (HHS) were recorded and compared one-year post-surgery.</p> Results <p>The distribution of FLs of the AC fragment on the anteroinferior wall, acetabulum, inner and outer sides of the ilium was similar between groups A and B except that group A had sparser FL distribution on the posterosuperior rim and fewer FLs extending into the sacroiliac joint. A comparable pattern of FLs of the QP fragments on the QP area and the RAS was also confirmed. On the RAS, group A exhibited fewer cranial transverse lines (8.5% vs. 25.0%) and more inverse lines (44.7% vs. 23.7%) than group B (<i>p</i> = 0.011). A higher incidence of PW fragments was identified in group A (72.3% vs. 53.9%, <i>p</i> = 0.042). The number of intra-articular fragments was higher in group A than group B (3.8 vs. 3.4, <i>p</i> = 0.031), but the composition of the articular surface was similar. The average HHS was 77.6 in group A and 83.0 in group B (<i>p</i> = 0.007), with excellent/good ratios of 59.5% and 74.7% (<i>p</i> &lt; 0.001), respectively.</p> Conclusions <p>The similar morphological patterns of ABC-AFs and favorable functional outcomes suggest that surgical principles for younger patients could be applicable to elderly patients, with careful considerations for osteoporosis and co-morbidities.</p>

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Comparative study of the 3D morphological differences in associated both-column acetabular fractures between elderly and young adults

  • 期刊论文

  • 发表日期：

    2025年2月25日

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  • Longxiang Shen,
  • Kai Ye,
  • Jianfei Tang,
  • Zhiquan An

摘要

Introduction

The occurrence of associated both-column acetabular fractures (ABC-AFs) is common in the elderly, yet their morphological characteristics compared to younger adults remain unclear.

Materials and methods

This retrospective study analyzed 123 cases of ABC-AFs: elderly patients (≥ 65 years, n = 47, group A) and younger adults (< 65 years, n = 76, group B). Using Mimics and 3-matic, fracture line (FL) distributions in the anterior column (AC), quadrilateral plate (QP), and posterior wall (PW) fragments were examined. Comparisons focused on the articular surface, ilium, QP area, and retro-acetabular surface (RAS). Harris hip scores (HHS) were recorded and compared one-year post-surgery.

Results

The distribution of FLs of the AC fragment on the anteroinferior wall, acetabulum, inner and outer sides of the ilium was similar between groups A and B except that group A had sparser FL distribution on the posterosuperior rim and fewer FLs extending into the sacroiliac joint. A comparable pattern of FLs of the QP fragments on the QP area and the RAS was also confirmed. On the RAS, group A exhibited fewer cranial transverse lines (8.5% vs. 25.0%) and more inverse lines (44.7% vs. 23.7%) than group B (p = 0.011). A higher incidence of PW fragments was identified in group A (72.3% vs. 53.9%, p = 0.042). The number of intra-articular fragments was higher in group A than group B (3.8 vs. 3.4, p = 0.031), but the composition of the articular surface was similar. The average HHS was 77.6 in group A and 83.0 in group B (p = 0.007), with excellent/good ratios of 59.5% and 74.7% (p < 0.001), respectively.

Conclusions

The similar morphological patterns of ABC-AFs and favorable functional outcomes suggest that surgical principles for younger patients could be applicable to elderly patients, with careful considerations for osteoporosis and co-morbidities.