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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2007 October;58(5):467-73
Complex fractures in the elderly
Cantu R. V., Koval K. J.
Department of Orthopedic Surgery Dartmouth Hitchcock Medical Center Lebanon, NH, USA
As the segment of the population greater than 65 years of age continues to grow, physicians are seeing an increasing number of osteoporosis related fractures. Although these so called ‘fragility fractures’ may result from a low energy mechanism, they can present a treatment challenge due to poor bone quality, compromised soft tissue status, and the patient’s overall medical condition. Deciding on whether to reconstruct the fracture or perform a joint arthroplasty is a common question. An increasing number of elderly patients are sustaining high energy injuries and fractures as well, most commonly in motor vehicle collisions. Here, the fracture pattern, degree of comminution, and difficulty obtaining stable fixation can result in a substantial challenge to the treating orthopedist. The optimal timing of surgery for the multiply injured elderly patient is another important question. The purpose of this report is to discuss some of these complex fractures in the elderly and to outline an approach to help manage them.