Minimally displaced geriatric acetabular fractures
Conditions
Interventions
Group 1: Operative treatment by percutaneous screw fixation
Patients allocated to the intervention group undergo operative stabilization of minimally displaced geriatric acetabular fractures by percu
Sponsors
BG Klinik Ludwigshafen
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Age = 65 years. 2. Radiologically confirmed minimally displaced geriatric acetabular fracture with a fracture gap and/or an articular step-off of < 5 mm. 3. Fracture resulting from low-energy trauma (e.g., a fall from standing height or a low-level fall). 4. Eligibility for both operative treatment by percutaneous screw fixation and conservative management. 5. Conservative treatment followed by pain-adapted full weight-bearing of the affected side according to the study protocol. 6. Ability to provide freely given and informed written consent following oral and written information regarding the objectives, procedures, and potential risks of the study. 7. Clinical equipoise confirmed by interdisciplinary specialist assessment, indicating that both operative treatment by percutaneous screw fixation and conservative management are considered equally appropriate and medically justifiable treatment options.
Exclusion criteria
Exclusion criteria: 1. Inability to provide informed consent due to severe dementia, cognitive impairment, or psychiatric disorders precluding a full understanding of the study and the provision of informed consent. 2. Bedridden status or inability to ambulate independently prior to the fracture event. 3. Severe visual or hearing impairment substantially interfering with the safe performance of the functional assessments or communication during the study procedures. 4. Pre-existing medical conditions or previous surgical interventions substantially affecting balance or gait (e.g., neurological disorders, vestibular disorders, previous joint replacement surgery, or surgery of the lower extremities). 5. Dependence on walking aids due to causes other than the current fracture (e.g., chronic musculoskeletal disorders or degenerative joint diseases). 6. Concomitant injuries of the lower extremities limiting walking, standing, or participation in the functional assessments.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Overall fall risk assessed 3 months after treatment initiation using a multidimensional fall risk score (range 1–11 points) combining standardized patient-reported measures of subjective fall risk and objective functional performance tests (Timed Up and Go Test, modified Timed Up and Go Test, 4-Stage Balance Test, Functional Reach Test, 5 Chair Rise Test, and gait analysis using the GaitRite® system). Higher scores indicate a higher risk of falling. | — |
Secondary
| Measure | Time frame |
|---|---|
| * Pain intensity 3 months after treatment initiation, assessed using the Numeric Analog Scale (NAS; 0–10 points). * Functional outcome 3 months after treatment initiation, assessed using the Lower Extremity Functional Scale (LEFS) and the Berg Balance Scale (BBS). * Radiological outcome 3 months after treatment initiation, including fracture healing, fracture displacement, joint congruency, implant position, and implant integrity. * Occurrence and number of fall events within the first 3 months after treatment initiation. * Patient- and treatment-related parameters, including complications, rehospitalizations, rehabilitation measures, length of hospital stay, pre-traumatic mobility, and comorbidities. | — |
Countries
Germany
Contacts
Public ContactFelix Metzger
BG Klinik Ludwigshafen
Outcome results
None listed