title: External fixation in the elderly.
abstract: Orthopaedic trauma is an increasingly common problem in geriatric patients. As demands of daily life and recreational activities are increasing in these patients, surgeons need to be able to manage geriatric fractures to achieve good functional results. Reduced bone quality in the elderly presents a considerable challenge and may preclude the use of established surgical stabilisation techniques that are performed in younger trauma patients. Furthermore, pre-existing medical conditions and considerable comorbidities in the elderly could complicate standard surgical procedures that younger patients would be offered. In this respect, application of external fixators represents a validated, minimally-invasive treatment opportunity. This review article summarises the use of external fixation in geriatric trauma patients for wrist fractures, proximal femoral fractures, pelvic fractures, and ankle fractures. Modern modifications, like pin coating with hydroxyapatite, and aspects of pin care will be discussed.
authors.affiliation: Department of Orthopaedic Trauma at Aachen University and Harald Tscherne Laboratory, University Hospital Aachen, Aachen, Germany.
authors.forename: Hagen
authors.initials: H
authors.lastname: Andruszkow
authors.affiliation: Department of Orthopaedic Trauma at Aachen University and Harald Tscherne Laboratory, University Hospital Aachen, Aachen, Germany.
authors.forename: Roman
authors.initials: R
authors.lastname: Pfeifer
authors.affiliation: Department of Orthopaedic Trauma at Aachen University and Harald Tscherne Laboratory, University Hospital Aachen, Aachen, Germany.
authors.forename: Klemens
authors.initials: K
authors.lastname: Horst
authors.affiliation: Department of Orthopaedic Trauma at Aachen University and Harald Tscherne Laboratory, University Hospital Aachen, Aachen, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Hildebrand
authors.affiliation: Department of Orthopaedic Trauma at Aachen University and Harald Tscherne Laboratory, University Hospital Aachen, Aachen, Germany. Electronic address: hpape@ukaachen.de.
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Pape
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D016267:External Fixators / Q000009:adverse effects; D005260:Female; D005264:Femoral Fractures / Q000473:pathology / Q000601:surgery*; D005592:Fracture Fixation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing; D016330:Frail Elderly; D006801:Humans; D008297:Male; D010384:Pelvic Bones / Q000293:injuries*; D011885:Radius Fractures / Q000473:pathology / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000473:pathology / Q000601:surgery*
keywords: Elderly; External fixation; Fracture; Geriatric; Pin infection