A single-centre retrospective cohort compared open reduction and internal fixation with acute total hip arthroplasty, with or without added osteosynthesis, in 60 patients aged 70 and over with isolated displaced acetabular fractures, median age 82 and median Charlson comorbidity index 5, across two periods governed by different institutional algorithms. Arthroplasty was followed by faster gait mobilisation and lower pain at discharge, 96% against 37% reporting a visual analogue score of 1 to 3, with no significant difference in complications, readmissions, length of stay or in-hospital mortality. The authors state that what is compared is an evolving treatment strategy rather than the two operations.
Why it is interesting: Early function after a fracture in patients over 80 with heavy comorbidity is rarely reported at all, though these endpoints stop at discharge.