[Do injuries of the upper extremity in geriatric patients end up in helplessness? A prospective study for the outcome of distal radius and proximal humerus fractures in individuals over 65].
In a prospective study 104 patients >or=65 years with distal radius fractures (DRF; n=52) and proximal forearm fractures (PHF; n=52) were followed up for a period of 4 months after injury. As an inception- cohort study, influence on treatment pattern was not part of the examination. A total of 53% of the DRF and 74% of the PHF patients underwent surgery. There were no significant changes in the ability of daily living management (IADL) with either fracture form. Functional outcome was better in PHF than DRF patients. PHF patients showed a high incidence in "fear of falling" throughout the whole study, whereas fear of falling rose significantly in DRF patients. 4% of DRF and 9.6% of PHF patients died during the observation period, while 6% of DRF and even 17% of PHF patients had to give up their own housekeeping. One third of both patient groups did not receive physiotherapy. In only 12% of DRF and 6% of PHF patients was osteoporosis treated. In both groups of patients there was a significant worsening in the ability of walking after injury, leading to two or more new falls in 24% of DRF and 28% of PHF patients.
Einsiedel
T
T
Abteilung für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, Universitätsklinikum Ulm, Steinhövelstrasse 9, 89075, Ulm, Germany. thomas.einsiedel@uniklinikulm.de
Becker
C
C
Stengel
D
D
Schmelz
A
A
Kramer
M
M
Däxle
M
M
Lechner
F
F
Kinzl
L
L
Gebhard
F
F
D000058:Accidental Falls / Q000706:statistics & numerical data; D000203:Activities of Daily Living / Q000145:classification*; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000534:rehabilitation; D015331:Cohort Studies; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D005593:Fracture Fixation, Internal / Q000534:rehabilitation; D005594:Fracture Fixation, Intramedullary / Q000534:rehabilitation; D005858:Germany; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data; D011446:Prospective Studies; D011885:Radius Fractures / Q000401:mortality / Q000534:rehabilitation*; D012784:Shoulder Fractures / Q000401:mortality / Q000534:rehabilitation*; D016019:Survival Analysis; D014954:Wrist Injuries / Q000401:mortality / Q000534:rehabilitation*