SLIDE 1
69 year old male
- Slipped and fell while trying to put his boat on
a trailer.
- Painful L hip, unable to walk.
- Currently working delivering televisions.
Geriatric Acetabular Fractures Avoid Complications Adam Starr, MD - - PowerPoint PPT Presentation
Geriatric Acetabular Fractures Avoid Complications Adam Starr, MD - - PowerPoint PPT Presentation
Geriatric Acetabular Fractures Avoid Complications Adam Starr, MD Chief, Orthopaedic Surgery Parkland Memorial Hospital Professor and Executive Vice Chair Department of Orthopaedic Surgery UT Southwestern Medical Center Dallas, Texas 69
SLIDE 2
SLIDE 3
SLIDE 4
SLIDE 5
SLIDE 6
SLIDE 7
SLIDE 8
SLIDE 9
SLIDE 10
SLIDE 11
SLIDE 12
SLIDE 13
SLIDE 14
SLIDE 15
SLIDE 16
SLIDE 17
SLIDE 18
SLIDE 19
SLIDE 20
SLIDE 21
SLIDE 22
SLIDE 23
SLIDE 24
Early Management
- Traction pin placed L leg
- Remainder of work-up negative
- Taken to OR 2 days after admission.
SLIDE 25
Operating Room
- Limited open reduction/percutaneous screw
fixation
- Pecten pubis fragment reduced.
- Bleeding slightly more than usual during sub-
iliacus dissection.
- Patient remained hemodynamically stable.
SLIDE 26
SLIDE 27
SLIDE 28
SLIDE 29
Post-op Course
- Hemoglobin and hematocrit trended slowly down.
- Remained hemodynamically stable.
- Transfused 4 units PRBCs.
- Abd CT scan revealed hematoma and possible arterial
extravasation
- Pelvic arteriogram done
– L obturator artery branches embolized with gelfoam and coils
- Hemoglobin and hematocrit stable afterwards.
- At 5 months, patient healed and returned to work
delivering TVs.
SLIDE 30
SLIDE 31
SLIDE 32
SLIDE 33
SLIDE 34
SLIDE 35
SLIDE 36
Risks of Acetabular Fracture Management in the Elderly
- Infection – obviated with perc technique
- Nonunion – rare in well vascularized bone
– No risk of pelvic discontinuity
- Post-traumaic arthritis
– Easily addressed with THA if it arises
- Excess scar, HO and hardware.
– Obviated with perc technique
SLIDE 37