Evidence map›Paper›PMID 40366425›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025

Mid-term outcomes of acetabular fractures treated with acute fix and replace versus ORIF in the elderly: a multicentric study with minimum 5-year follow-up.

Amarildo Smakaj, Giuseppe Rovere, Concetto Battiato, Rocco Erasmo, Domenico De Mauro, Andrea Fidanza, Fernando De Maio, Pasquale Farsetti, Francesco Liuzza

Abstract readMulticenter StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Amarildo SmakajPoliclinico Tor Vergata, Rome, Italy. amarildo.smakaj@gmail.com.
Giuseppe RoverePoliclinico Tor Vergata, Rome, Italy. rovere292@hotmail.com.
Concetto BattiatoOspadale Mazzoni, Ascoli Piceno, Italy.
Rocco ErasmoAzienda USL di Pescara, Pescara, Italy.
Domenico De MauroAgostino Gemelli University Polyclinic, Rome, Italy.
Andrea FidanzaUniversity of L'Aquila, L'Aquila, Italy.
Fernando De MaioUniversity of Rome Tor Vergata, Rome, Italy.
Pasquale FarsettiUniversity of Rome Tor Vergata, Rome, Italy.
Francesco LiuzzaUniversity of Rome Tor Vergata, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAcetabular fractures in elderly patients are increasing and present complex management challenges. This multicentric retrospective study compares mid-term clinical and radiographic outcomes of acute "fix and replace" versus ORIF, focusing on implant survival, complications, and functional performance at a minimum five-year follow-up, addressing the current lack of extended outcome data.

methodsThis study is an update of a previously published multicentric retrospective cohort including patients aged ≥ 60 years with acetabular fractures treated surgically at three hospitals in central Italy between 2013 and 2025. Patients received either acute "fix and replace" (ORIF combined with acute THA) or ORIF alone, with a minimum clinical and radiographic follow-up of five years. Functional outcomes were assessed using PROMs (SF-12, PDI) and clinician-based scores (HHS, Modified Merle d'Aubigné and Postel). Radiographs were reviewed for healing, implant integrity, osteolysis, loosening, osteoarthritis, and heterotopic ossifications. Complications and implant survival were analyzed using Kaplan-Meier curves with revision surgery as the endpoint.

resultsA total of 41 patients (21 ORIF, 20 CHP) completed a minimum five-year follow-up. No significant differences were found between groups regarding age, BMI, or follow-up duration. Two revisions to total hip arthroplasty occurred in the ORIF group, with no revisions in the CHP group. Radiographic findings, including heterotopic ossifications and implant loosening, were comparable. Functional scores (HHS, MAPM, SF-12 PCS and MCS) showed no significant differences between groups at both two and five years. The CHP group, however, demonstrated significantly lower pelvic discomfort index (PDI) scores at 60 months (p = 0.04). No significant intra-group variations were observed over time.

conclusionBoth ORIF and CHP provide satisfactory mid-term outcomes in elderly patients with acetabular fractures. However, CHP demonstrated fewer reoperations and better pelvic discomfort scores at five years. These findings support the growing evidence favoring acute fix-and-replace strategies in this population.

Indexed as

AcetabulumArthroplasty, Replacement, HipFracture Fixation, InternalFractures, BoneAgedAged, 80 and overFemaleFollow-Up StudiesHumansItalyMaleMiddle AgedPostoperative ComplicationsProsthesis FailureRadiographyReoperationAcetabular fracturesCHPCombined hip procedureElderly patientsFix and replaceFunctional resultsMid-term outcomesOpen reduction and internal fixationORIFTotal hip arthroplasty

Identifiers

PMID40366425
PMCPMC12078442

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.