• Derek Butterwick, Steve Papp, Wade Gofton, Allan Liew, and Paul E Beaulé.
• Division of Orthopedic Surgery, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada. E-mail address for S. Papp: spapp@toh.on.ca.
• J Bone Joint Surg Am. 2015 May 6; 97 (9): 758-68.

AbstractAcetabular fracture patterns in the elderly, with increased involvement of the anterior column, quadrilateral plate comminution, medialization of the femoral head, and marginal impaction, differ from those noted among a younger cohort. Poor prognostic factors for open reduction and internal fixation (ORIF) are posterior wall comminution, marginal impaction of the acetabulum, a femoral head impaction fracture, a so-called gull sign, and hip dislocation. The rate of conversion to total hip arthroplasty following formal ORIF has been reported to be 22% at a mean of twenty-nine months. Total hip replacement after an acetabular fracture generally yields good clinical results; however, in the acute setting, it must be combined with proper stable fracture fixation.Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

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