Abstract text (incl. references and figure legends)
Introduction: the treatment of acetabular fractures in the elderly poses severe problems to designers and surgeons. Known problems are stability due to porosis, difficulties with prosthetics due to instability, as well as the lower capacity to surgery due to age, and the severe complications resulting from the bed-time condition. Literature reports joint arthrosis after synthetic treatment of fractures.
Material and method: knowing the complications, we have developed a new implant, which - at least on a theoretical level - can prevent the complications. Hip revision and plating systems are in use in our country. We compared the combination of these with purely synthetic options. All applications must be preceded by an appropriate biomechanical study. For this, we chose finite element modeling (3DMaxStudio, Solidworks Simulation). According to the results - with appropriate permits - we started to use the method in different indications, i.e., old-age injury, acetabular cup instability, and non-union.
Results: in the elder bone, the FEM showed a clear stability advantage of the hybrid method. Since the technique provides the opportunity to optimize the implants, we modified dimensions based on the computer prediction. We developed a suitable ring-shaped acetabular cup system, considering the desired implant dimensions. Accordingly, we used it in various indications (fracture of the acetabulum in the elders, pseudo-joint, bone loosening around a septic vape). FEM already showed relevance during the initial pilot application. Our initial patients regained their ability to walk immediately, and we did not notice any loosening of the acetabular cup.
Conclusion: acetabular fractures in the elderly, similar to hip fractures in the elderly, remain a problem. Our theoretical research and initial results prove that the hybrid procedure used in acetabulum fractures in the elderly, combining osteosynthetic and prosthetic principles, can be a safe, and stable system.
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