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[Endoprostheses in geriatric traumatology].

B Buecking1, D Eschbach2, C Bliemel2

  • 1Zentrum für Orthopädie und Unfallchirurgie, Universitätsklinikum Gießen und Marburg GmbH,Standort Marburg, Baldingerstraße, 35043, Marburg, Deutschland. buecking@med.uni-marburg.de.

Der Orthopade
|December 15, 2016
PubMed
Summary

Primary joint replacement is a growing treatment for geriatric fractures, especially for hip and shoulder injuries. More research is needed for elbow and knee fractures to determine the best approach.

Keywords:
Articular fractureFracture prosthesisGeriatric fractureOrtho-geriatricsProximal femural fracture

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Area of Science:

  • Geriatric Traumatology
  • Orthopedic Surgery
  • Arthroplasty

Background:

  • Geriatric traumatology is a growing field due to demographic shifts.
  • The efficacy of primary joint replacement versus joint-preserving fixation for periarticular fractures in the elderly is debated.

Purpose of the Study:

  • To evaluate the significance of prosthetic joint replacement in geriatric patients with periarticular fractures.
  • Comparison of primary arthroplasty with osteosynthesis and conservative treatments.

Main Methods:

  • A selective literature review was conducted.
  • Studies and recommendations on primary arthroplasty for hip, shoulder, elbow, and knee fractures were identified.

Main Results:

  • Primary arthroplasty's importance varies by joint in geriatric fractures.
  • Prosthetic joint replacement is the gold standard for displaced femoral neck fractures.
  • Reverse shoulder arthroplasty is an alternative for complex proximal humerus fractures.
  • Definitive recommendations for elbow and knee fractures are pending due to limited data; replacement is reserved for unreconstructible surfaces.

Conclusions:

  • The role of primary joint replacement in geriatric fractures is expected to expand.
  • Further large-scale studies are necessary to guide treatment decisions between joint replacement and internal fixation for shoulder, elbow, and knee fractures.