Research progress on osteoporotic acetabular fractures in the elderly_West China Medical Journal

Authors：

WANG Qin , PU Xingxiao , HAN Guangtao , SUN Shuo ,  KANG Pengde

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

KANG Pengde, Email: kangpengde69@126.com

Keywords：

Osteoporosis; acetabular fractures; epidemiology; treatment

DOI：

10.7507/1002-0179.202510003

Video：

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Abstract Full text Figures/Tables Video References Cited by

With population aging, the incidence of osteoporotic acetabular fractures in the elderly is rising annually. This review outlines the epidemiology, pathogenesis, and biomechanical characteristics of elderly osteoporotic acetabular fractures, and assesses the value of clinical classification systems. It systematically clarifies treatment goals centered on restoring joint stability and enabling early rehabilitation. Furthermore, this paper comprehensively discusses therapeutic strategies—including non-surgical management, open reduction and internal fixation, minimally invasive techniques, and total hip arthroplasty—while emphasizing the importance of perioperative multidisciplinary collaboration and standardized anti-osteoporosis therapy. Finally, future directions in intelligent medicine and biomaterials technology are envisioned to provide a clinical reference.

Citation： WANG Qin, PU Xingxiao, HAN Guangtao, SUN Shuo, KANG Pengde. Research progress on osteoporotic acetabular fractures in the elderly. West China Medical Journal, 2026, 41(7): 1196-1201. doi: 10.7507/1002-0179.202510003 Copy

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1. 《中國老年骨質疏松癥診療指南(2023)》工作組, 中國老年學和老年醫學學會骨質疏松分會, 中國醫療保健國際交流促進會骨質疏松病學分會, 等. 中國老年骨質疏松癥診療指南(2023)[J]. 中華骨與關節外科雜志, 2023, 16(10): 865-885.
2. Morin SN, Leslie WD, Schousboe JT. Schousboe, osteoporosis: a review[J]. JAMA, 2025, 334(10): 894-907.
3. 史曉林, 劉康. 老年性骨質疏松癥中西醫結合診療指南[J]. 中國骨質疏松雜志, 2024, 30(7): 937-946.
4. 宋純理. 中國老年髖部及椎體骨折大數據分析報告[J]. 中華骨質疏松和骨礦鹽疾病雜志, 2024, 17(4): 303-307.
5. 楊明輝, 要對老年髖臼骨折進行更深入的探索[J]. 骨科臨床與研究雜志, 2020, 5(6): 321-323.
6. 李明. 髖臼四方區解剖型自鎖定鋼板設計的數字化研究[R]. 寧波: 寧波市第六醫院, 2021.
7. Hoellen IP, Mentzel M, Bischoff M, et al. Acetabular fractures in the elderly - primary endoprosthesis[J]. Orthopade, 1997, 26(4): 348-353.
8. Toro JB, Hierholzer C, Helfet DL. Acetabular fractures in the elderly[J]. Bull Hosp Jt Dis, 2004, 62(1/2): 53-57.
9. Pagenkopf E, Grose A, Partal G, et al. Acetabular fractures in the elderly: treatment recommendations[J]. HSS J, 2006, 2(2): 161-171.
10. Cornell CN. Management of acetabular fractures in the elderly patient[J]. HSS J, 2005, 1(1): 25-30.
11. Borgstr?m F, Karlsson L, Orts?ter G, et al. Fragility fractures in Europe: burden, management and opportunities[J]. Arch Osteoporos, 2020, 15(1): 59.
12. Gong XF, Li XP, Zhang LX, et al. Current status and distribution of hip fractures among older adults in China[J]. Osteoporos Int, 2021, 32(9): 1785-1793.
13. Si L, Winzenberg TM, Jiang Q, et al. Projection of osteoporosis-related fractures and costs in China: 2010-2050[J]. Osteoporos Int, 2015, 26(7): 1929-1937.
14. 朱潔云, 高敏, 宋秋韻, 等. 中國老年人骨質疏松癥患病率的 Meta 分析[J]. 中國全科醫學, 2022, 25(3): 346-353.
15. 中國健康促進基金會基層醫療機構骨質疏松癥診斷與治療專家共識委員會. 基層醫療機構骨質疏松癥診斷和治療專家共識(2021) [J]. 中國骨質疏松雜志, 2021, 27(7): 937-944.
16. 吳雅文, 高靜媛, 彭倩倩, 等. 老年人群骨質疏松癥的研究進展[J]. 中國現代醫生, 2025. 63(18): 132-135.
17. Hua Y, Li Y, Zhou J, et al. Mortality following fragility hip fracture in China: a record linkage study[J]. Arch Osteoporos, 2023, 18(1): 105.
18. Hayes PJ, Carroll CM, Roberts CS, et al. Operative treatment of acetabular fractures in the medicare population[J]. Orthopedics, 2013, 36(8): e1065-1070.
19. Melhem E, Riouallon G, Habboubi K, et al. Epidemiology of pelvic and acetabular fractures in France[J]. Orthop Traumatol Surg Res, 2020, 106(5): 831-839.
20. Rinne PP, Laitinen MK, Kannus P, et al. The incidence of pelvic fractures and related surgery in the Finnish adult population: a nationwide study of 33, 469 patients between 1997 and 2014[J]. Acta Orthopaedica, 2020, 91(5): 587-592.
21. Fuggle NR, Beaudart C, Bruyère O, et al. Evidence-based guideline for the management of osteoporosis in men[J]. Nat Rev Rheumatol, 2024, 20(4): 241-251.
22. Gary JL, Paryavi E, Gibbons SD, et al. Effect of surgical treatment on mortality after acetabular fracture in the elderly: a multicenter study of 454 patients[J]. J Orthop Trauma, 2015, 29(4): 202-208.
23. Ernstberger H, Pieroh P, H?ch A, et al. Minimally displaced acetabulum fractures in geriatric patients: a comparison of open, percutaneous and non-operative treatment from the German pelvic injury register data[J]. Eur J Trauma Emerg Surg, 2021, 47(6): 1763-1771.
24. Rommens PM, Schwab R, Handrich K, et al. Open reduction and internal fixation of acetabular fractures in patients of old age[J]. Int Orthop, 2020, 44(10): 2123-2130.
25. Laflamme GY, Hebert-Davies J, Rouleau D, et al. Internal fixation of osteopenic acetabular fractures involving the quadrilateral plate[J]. Injury, 2011, 42(10): 1130-1134.
26. Borens O, Wettstein M, Garofalo R, et al. Treatment of acetabular fractures in the elderly with primary total hip arthroplasty and modified cerclage. Early results[J]. Unfallchirurg, 2004, 107(11): 1050-1056.
27. Kennedy IW, Meek RMD. Latest developments in arthroplasty for hip fractures[J]. Bone Joint J, 2024, 106-B(12): 1372-1376.
28. Hoong CWS, Saul D, Khosla S, et al. Advances in the management of osteoporosis[J]. BMJ, 2025, 390: e081250.
29. Long B, Shalaby M, Gottlieb M. Managing analgesia for hip fractures[J]. Ann Emerg Med, 2025, 86(6): 616-624.
30. Luo Y. Hip fractures: clinical, biomaterial and biomechanical insights into a common health challenge[J]. Bioengineering (Basel), 2025, 12(6): 580.
31. Herscovici D Jr, Lindvall E, Bolhofner B, et al. The combined hip procedure: open reduction internal fixation combined with total hip arthroplasty for the management of acetabular fractures in the elderly[J]. J Orthop Trauma, 2010, 24(5): 291-296.
32. Dyskin E, Hill BW, Torchia MT, et al. A survey of high- and low-energy acetabular fractures in elderly patients[J]. Geriatr Orthop Surg Rehabil, 2019, 10: 2151459319870426.
33. Goyal T, Singh G, Kumar Tripathy S, et al. Acetabulum fractures in elderly: a systematic review of fracture pattern and treatment[J]. J Clin Orthop Trauma, 2020, 11(6): 989-1001.
34. Heimke IM, Scarcella NR, Simske NM, et al. Surgical versus nonsurgical management of acetabular fractures with associated patterns in elderly patients:factors affecting outcomes[J]. J Am Acad Orthop Surg Glob Res Rev, 2022, 6(3): e22.00014.
35. 樊仕才, 羅殿中, 侯志勇. 骨盆髖臼周圍手術[M]. 北京: 人民衛生出版社, 2021: 682.
36. Zhang R, Yin Y, Li A, et al. Three-column classification for acetabular fractures: introduction and reproducibility assessment[J]. J Bone Joint Surg Am, 2019, 101(22): 2015-2025.
37. 張瑞鵬, 蔡鴻敏, 樊仕才, 等. 基于三柱分型的髖臼骨折精準診療專家共識(2023 版)[J]. 中華創傷雜志, 2023, 39(10): 865-875.
38. Herath SC, Pott H, Rollmann MFR, et al. Geriatric acetabular surgery: letournel’s contraindications then and now-data from the German pelvic registry[J]. J Orthop Trauma, 2019, 33: S8-S13.
39. Cacciola G, Aprato A, Branca Vergano L, et al. Is non-operative management of acetabular fracture a viable option for older patients? A systematic review of the literature for indication, treatments, complications and outcome[J]. Acta Biomed, 2022, 92(S3): e2021555.
40. 王偉斌, 袁欣華, 扶青松, 等. 骨質疏松性肱骨近端骨折 PMMA 骨水泥強化螺釘鋼板固定的有限元分析[J]. 中國骨傷, 2023, 36(3): 262-267.
41. 郝林杰, 文鵬飛, 張育民, 等. 切開復位內固定術聯合全髖關節置換術治療老年髖臼骨折[J]. 中國骨與關節損傷雜志, 2023, 38(8): 793-797.
42. 顧珊菱, 許巖, 楊光, 等. 骨科手術機器人輔助下經皮螺釘內固定治療老年骨盆和髖臼骨折的療效及對生活質量的影響[J]. 中國老年學雜志, 2020, 40(5): 1001-1004.
43. 黃曉曼, 羅麗琴. 骨盆骨折患者術后切口感染危險因素分析[J]. 護理實踐與研究, 2021, 18(19): 2872-2875.
44. Vanderschot P. Treatment options of pelvic and acetabular fractures in patients with osteoporotic bone[J]. Injury, 2007, 38(4): 497-508.
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