B Bücking1, C Neuerburg2, M Knobe3, U Liener4. 1. Klinik für Orthopädie, Unfallchirurgie und Alterstraumatologie, DRK-Kliniken Nordhessen Gemeinnützige GmbH, Standort Wehlheiden, Hansteinstr. 29, 34121, Kassel, Deutschland. buecking@drk-nh.de. 2. Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität München, München, Deutschland. 3. Klinik für Orthopädie und Unfallchirurgie, Luzerner Kantonsspital, Luzern, Schweiz. 4. Klinik für Orthopädie, Unfallchirurgie und Wiederherstellungschirurgie, Vinzenz von Paul Kliniken gGmbH Marienhospital Stuttgart, Stuttgart, Deutschland.
Abstract
BACKGROUND: Fragility fractures are fractures in multimorbid, geriatric patients. Currently, their number is already high and is likely to increase in the future. OBJECTIVE: This article gives an overview of the principles in the management of patients with fragility fractures. MATERIAL AND METHODS: A selective literature review was performed to describe the epidemiology and relevance of fragility fractures. In addition, the principles of the perioperative management and surgical treatment of patients with fragility fractures are shown. RESULTS: Due to the significant number of comorbidities, the treatment of patients with fragility fractures represents an interdisciplinary challenge. Ideally, treatment should be carried out in an interdisciplinary team under the leadership of orthopedic surgeons and geriatricians. Treatment should be based on consensus guidelines, which have been adapted to the local circumstances. Attention should be paid to some special aspects of the surgical treatment in this vulnerable patient cohort. Important are optimal soft tissue management, cement augmentation procedures and joint replacement in cases of periarticular fractures. CONCLUSION: There is evidence that with optimal care the treatment of patients with fragility fractures can be significantly improved.
BACKGROUND:Fragility fractures are fractures in multimorbid, geriatric patients. Currently, their number is already high and is likely to increase in the future. OBJECTIVE: This article gives an overview of the principles in the management of patients with fragility fractures. MATERIAL AND METHODS: A selective literature review was performed to describe the epidemiology and relevance of fragility fractures. In addition, the principles of the perioperative management and surgical treatment of patients with fragility fractures are shown. RESULTS: Due to the significant number of comorbidities, the treatment of patients with fragility fractures represents an interdisciplinary challenge. Ideally, treatment should be carried out in an interdisciplinary team under the leadership of orthopedic surgeons and geriatricians. Treatment should be based on consensus guidelines, which have been adapted to the local circumstances. Attention should be paid to some special aspects of the surgical treatment in this vulnerable patient cohort. Important are optimal soft tissue management, cement augmentation procedures and joint replacement in cases of periarticular fractures. CONCLUSION: There is evidence that with optimal care the treatment of patients with fragility fractures can be significantly improved.
Entities:
Keywords:
Aged; Interdisciplinary health team; Multimorbidity; Orthogeriatric comanagement; Traumatology
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