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Background  Elderly patients have more special medical needs when compared with young ones; thus, the results of open reduction and internal fixation (ORIF) for acetabular fractures should be stratified by age in these patients. This study seeks to determine whether the age of the patient influences the results of the ORIF for acetabular fractures.    Methods  We performed a retrospective analysis of prospectively collected data on 53 elderly patients with displaced acetabular fractures who underwent ORIF between May 2004 and May 2011. Patients were divided into two groups by age: young–old group (60–74 years) and old–old group (75–90 years). The number of patients in each group was 28 and 25. The reduction quality and clinical function was evaluated using the Matta criteria and modified Postel Merle D’Aubigne Score, respectively. Operative time, bleeding amount, and complications were recorded.    Results  Patients in old–old group had significantly lower anatomical reduction rate ( p  = 0.024), less operative time ( p  = 0.021), and less bleeding amount ( p  = 0.016) than those in the young–old group. The reduction quality in the young–old group was strongly associated with clinical function ( p  < 0.05). However, no difference in clinical function was detected among the different reduction qualities in the old–old group ( p  > 0.05). Moreover, no significant difference in clinical functions ( p  = 0.787) and complications ( p  = 0.728) was detected between the two groups.    Conclusions  Old–old patients may expect comparable clinical functions and complications with young–old patients. The reduction quality in old–old patients may be not significantly associated with clinical function. Different treatment strategies may be applied for acetabular fractures with ORIF in different age groups.    Electronic supplementary material  The online version of this article (10.1186/s12891-017-1817-5) contains supplementary material, which is available to authorized users.

Influence of age on results following surgery for displaced acetabular fractures in the elderly