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Successful Management of an Acetabular Fracture Associated With Comorbidities in an 80-Year-Old Patient: A Case
Ghassan A Alnajjar1, Ahmad Ezzelden1, Mostafa Elgendy1
1Orthopedic Surgery, Saudi German Hospital, Jeddah, SAU.
Abstract:
Pelvic fractures, particularly acetabular fractures, pose major problems for individuals with advanced age due to comorbidities and poor bone quality. Road traffic accidents (RTAs) are a leading cause of high-energy injuries. This case report describes the treatment of an 80-year-old patient with hypertension, pulmonary fibrosis, and morbid obesity who suffered an acetabular fracture after an RTA. An 80-year-old patient was received in the emergency room 10 days after the RTA. X-rays and CT scans indicated an anterior column with a posterior hemi-transverse fracture, and the quadrilateral plate was completely displaced. A CT angiography revealed deep vein thrombosis (DVT) in the lower limb, prompting the start of anticoagulant medication and the insertion of an inferior vena cava (IVC) filter. The modified Stoppa technique was used to definitively fix the acetabular fracture. The corona mortis was found and safeguarded throughout the surgery. Following surgery, the patient avoided weight-bearing activities for one month before beginning non-weight-bearing mobilization and physical therapy. At the first clinic visit following discharge, the patient reported total pain relief and successful mobilization with a wheelchair. The treatment of acetabular fractures in older patients with comorbidities necessitates a specialized, multidisciplinary approach. This case indicates that, despite major hurdles, successful outcomes can be achieved through appropriate surgical and postoperative techniques. Future research should focus on refining these methods to enhance the prognosis in this patient population.
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