Open Reduction and Internal Fixation (ORIF) for Acetabular Fractures in the Elderly: A Systematic Review and Meta-Analysis

Objectives: To evaluate the outcomes of open reduction and internal fixation (ORIF) in older adults with acetabular fractures, with a focus on postoperative complications, mortality, and conversion to total hip arthroplasty (THA). Methods: We systematically reviewed studies published between September ۲۰۱۳ and February ۲۰۲۵ in Web of Science, PubMed, Embase, Scopus, and the Cochrane Library. Studies reporting postoperative outcomes of ORIF in elderly patients aged ≥۶۵ years were included. Data extraction and quality assessment were performed independently by two reviewers. Statistical analyses were conducted using Comprehensive Meta-Analysis software, version ۳.۰. Results: Twenty-one studies involving ۲,۴۱۰ patients were included in the analysis. Follow-up duration ranged from ۱۲ to ۹۶ months. The pooled mortality rate after ORIF was ۱۱.۰% (۹۵% CI: ۷.۰%–۱۶.۷%). The pooled complication rate was ۲۶.۵% (۹۵% CI: ۲۱.۳%–۳۲.۴%), and the pooled rate of conversion to THA was ۲۰.۰% (۹۵% CI: ۱۵.۲%–۲۶.۰%). The pooled infection rate was ۵.۸% (۹۵% CI: ۴.۲%–۷.۹%). Fixation failure occurred in ۱۲.۶% of patients (۹۵% CI: ۹.۸%–۱۵.۹%) and was primarily attributed to secondary loss of reduction, implant loosening, or hardware breakage, often requiring revision surgery or conversion to THA. Conclusion: ORIF in elderly patients with acetabular fractures is associated with substantial risks, including a high complication rate and a notable likelihood of conversion to THA. Alternative treatment strategies, such as primary THA or nonoperative management, should be considered in selected patients. Level of evidence: I

کلیدواژه ها:

Acetabular fracture ، complication ، Elderly ، Mortality ، ORIF ، Total hip arthroplasty