The Combined Hip Procedure: Open Reduction Internal Fixation Combined with Total Hip Arthroplasty for the Management of Severe Acetabular Fractures in the Elderly: A Case Report

Rolandi Indra Pramukti, Mohammad Zaim Chilmi, Jifaldi A.M.D. Sedar

Abstract


Rolandi Indra Pramukti1, Mohammad Zaim Chilmi2 and Jifaldi A.M.D. Sedar3

Fellow of Indonesia Hip and Knee Society, Orthopaedic and Traumatology Surgery Department, dr. Soetomo General Hospital, Surabaya, Indonesia

Senior Consultant Orthopaedic and Traumatology Surgery Department, dr. Soetomo General Hospital, Surabaya, Indonesia

3 Consultant Orthopaedic and Traumatology Surgery Department, dr. Soetomo General Hospital, Surabaya, Indonesia

Abstract

Acetabular fractures in the elderly are marked by many variability in terms of patient and fracture characteristics. Successful outcomes depend on application of highly individualized (tailor made) management principles. The indications and outcomes associated with various management options, including closed treatment, open reduction internal fixation, and direct or staged total hip arthroplasty. Proper initial management choices are critical, as early failures and subsequent salvage surgery can be accompanied with morbidity. Clinical results after ORIF closely follow the quality of articular reduction and the ability to maintain a congruent reduction of the hip joint. Fracture characteristics and ability to achieve anatomic-articular reduction, should be treated with ORIF. However, fracture characteristics predictive, prior to early post-traumatic arthritis should be treated with simultaneous ORIF and THA (Combine Hip Procedure, CHP). The case presented is one referral institutions treatment algorithm and management approach in dr. Soetomo general hospital.

Keywords: acetabulum fracture. elderly. combine hip procedure. ORIF. total hip arthroplasty 


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DOI: https://doi.org/10.46355/hipknee.v5i1.124

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