[Individual aspects in eldery patients with fragility fractures]

Area of Science:

• Geriatric Trauma
• Radiology
• Orthopedics

Background:

• Aging populations lead to increased emergency visits for low-energy trauma in elderly patients.
• Fragility fractures, often in the proximal humerus, distal radius, spine, pelvis, or hip, are common in this demographic.
• Pre-existing conditions, polypharmacy, and frailty exacerbate fracture risk.

Purpose of the Study:

• To highlight diagnostic challenges of geriatric trauma fractures, particularly pelvic ring insufficiency fractures.
• To emphasize the importance of advanced imaging and osteoporosis evaluation in elderly patients with suspected fractures.
• To underscore the need for collaborative care between radiologists and trauma surgeons.

Main Methods:

• Plain X-rays are often insufficient for diagnosing geriatric trauma fractures.
• Cross-sectional imaging, including computed tomography (CT), dual-energy CT (DECT), and magnetic resonance imaging (MRI), is recommended for suspected fractures.
• Bone density measurement via dual energy X-ray absorptiometry (DXA) is the standard for osteoporosis diagnosis; high-resolution peripheral quantitative CT (HR-pQCT) may be used in specific cases.

Main Results:

• Cross-sectional imaging aids in reliable fracture evaluation and identification of older fractures in geriatric trauma patients.
• Advanced imaging is particularly useful in cognitively impaired patients or unclear fall scenarios.
• Careful consideration of risks, such as contrast agent use in renal impairment, is necessary for individual patient management.

Conclusions:

• Accurate detection of fragility fractures in the elderly presents unique challenges.
• Prompt and adequate therapy initiation is crucial for geriatric trauma patients.
• Effective communication and collaboration between radiologists and trauma surgeons are essential for optimal patient outcomes.