[Fracture management in the aged]

Fracture care in a geriatric population should lead to a mobilisation with full weight bearing as soon as possible after the accident. Osteoporosis and associated preexisting disease influences the kind of fracture care as well as the social situation. A retrospective analysis of 888 consecutive patients from 1994 to 1998 showed that the fracture risk for a second independent bony lesion was 5.2% in this population with a mean age of 83.4 years (75 y-97.2 y). 946 fractures were treated operatively with a overall reoperation rate of 10%. 3.1% were soft tissue revisions due to infection, 2.0% were because of implant failure in connection with a deep infection and 5.2% of the reoperation were indicated because of implant failure alone. Distribution of complications showed the advantage of closed, indirect reduction and intramedullary devices and primary hemiarthroplasty in femoral and humeral head fractures.