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[Fractures of the upper extremity in the elderly]
M R Sarkar1, I P Hoellen, L Kinzl
1Abteilung für Unfall-, Hand- und Wiederherstellungschirurgie, Universität Ulm.
Problem:
The primary goal in treating fractures in elderly persons is safe and rapid restoration of their functional capabilities to secure independence in everyday activities. The intention of this paper is to present an overview of treatment principles useful in this age group.
Methods:
We analysed a series of 404 patients above the age of 70 years who underwent surgery for fractures of the arm between 1981 and 1997.
Results:
Diaphyseal fractures are less frequent in this age group and their treatment does not differ significantly from principles established for younger patients. The majority of fractures of the proximal humerus and the distal radius can be treated by conservative means. Unstable fractures are frequent in the distal humerus and the olecranon requiring operative reduction and osteosynthesis.
Conclusions:
Preferred operative techniques in aged persons inflict minimal surgical trauma and have a low rate of complications and secondary interventions. In contrast, anatomical reconstruction has the highest priority in younger individuals.