Fracture treatment in the elderly.
With an ever increasing percentage of elderly people among the population fracture management in the aged is of increasing importance in the field of traumatology, since people between the ages of 60 and 80 will constitute the largest subpopulation by 2030. Due to relevant interindividual differences concerning physical constitution and comorbidity this group resembles an extremely inhomogenic population of patients. Discrepancies between biologic and chronologic age make a careful selection of suitable therapeutic strategies individually adapted to a single patient's situation necessary. For the biologically younger patient with good compliance conservative treatment or minimal osteosynthetic procedures requiring partial weight bearing might constitute a reasonable and appropriate therapeutic option whereas for biologically older patients with relevant co-morbidity early mobilisation with short hospitalisation periods is of the highest priority. This is why in these cases osteosynthetic procedures with implants that allow full weight bearing initially after surgery should be preferred. Even though in advanced age there is an increasing risk of fractures in general -- due to increasing incidence of falls and decreasing bone mineral density -- the majority of fractures in elderly is located in the proximal femur, the proximal humerus and the distal radius. Therefore, therapy of fractures in these typical locations shall in recognition of the particular characteristics of the advanced age be displayed in this article.
Niemeyer
P
P
Department of Traumatology and Orthopedic Surgery, Albert-Ludwig-University, Freiburg, Germany. PhNiemeyer@aol.com
Hauschild
O
O
Strohm
P C
PC
Müller
Ch A
ChA
Südkamp
N P
NP
Köstler
W
W
D000368:Aged; D000369:Aged, 80 and over; D005264:Femoral Fractures / Q000601:surgery*; D006801:Humans; D011885:Radius Fractures / Q000601:surgery*; D012784:Shoulder Fractures / Q000601:surgery*