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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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Combined Upper-Lower Extremities Fractures in the Elderly.

Cindy A Limanto1, Michelle E Gary2, Ghulam H Saadat3

  • 1Department of Surgery, Trauma Services, OSF Healthcare St Francis Medical Center, Peoria, IL, USA.

The American Surgeon
|March 9, 2023
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Advanced age significantly increases the risk of simultaneous upper and lower extremity fractures from falls. These findings highlight the need for targeted prevention strategies to reduce fall-related injuries in older adults.

Keywords:
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Area of Science:

  • Orthopedic Surgery
  • Geriatric Medicine
  • Trauma Surgery

Background:

  • Age-related bone loss contributes to increased fracture risk, particularly fragility fractures.
  • Simultaneous upper and lower extremity fractures present a significant clinical challenge, especially in older populations.
  • Understanding risk factors for these combined injuries is crucial for effective prevention and management.

Purpose of the Study:

  • To identify risk factors associated with simultaneous upper-lower extremity fractures.
  • To investigate the specific impact of advanced age on the occurrence of combined humerus-femur fractures.
  • To analyze data from a large trauma database to assess fracture patterns in relation to age.

Main Methods:

  • Retrospective analysis of the American College of Surgeons-Trauma Quality Improvement Program (ACS-TQIP) database (2017-2019).
  • Identification of patients sustaining fractures from ground-level falls.
  • Statistical analysis to determine odds ratios for combined upper-lower extremity fractures across different age groups, adjusting for covariates.

Main Results:

  • A total of 403,263 femur fractures and 7,575 combined upper-lower extremity (humerus-femur) fractures were identified.
  • Increasing age was significantly associated with higher odds of combined upper-lower extremity fractures.
  • Patients aged 75-89 had nearly double the odds (OR 1.90) of combined fractures compared to younger cohorts, even after adjustment.

Conclusions:

  • Advanced age is a significant risk factor for traumatic combined upper-lower extremity fractures resulting from falls.
  • Prevention strategies targeting fall reduction and bone health in the elderly are essential.
  • Reducing the incidence of simultaneous upper-lower extremity injuries can decrease patient morbidity and healthcare burden.