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Prophylactic fixation in elderly fractures: Preventive breakthrough or unnecessary intervention?

Mohamed Sameer1, Sathish Muthu2,3, Srujun Vadranapu4

  • 1Department of Orthopaedics, Sri Ramachandra Institute of Higher Education and Research, Chennai 600116, Tamil Nādu, India.

World Journal of Orthopedics
|December 8, 2025
PubMed
Summary

Prophylactic fixation (ProFix) for elderly osteoporosis patients can prevent fractures, improving mobility and lowering healthcare costs. Early intervention and risk assessment are key to reducing complications and enhancing well-being.

Keywords:
Bone healthElderly patientsFracture preventionOsteoporotic fracturesPredictive analyticsProphylactic fixationProximal femur

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Area of Science:

  • Geriatric Medicine
  • Orthopedic Surgery
  • Preventive Healthcare

Background:

  • Osteoporosis significantly increases fracture risk in the elderly, leading to severe complications.
  • Current management often focuses on treatment after fractures occur, missing opportunities for prevention.
  • Undiagnosed osteoporosis is prevalent, highlighting the need for proactive strategies.

Purpose of the Study:

  • To review the evidence supporting prophylactic fixation (ProFix) of the proximal femur in elderly patients with osteoporosis.
  • To evaluate the potential benefits of ProFix in preventing fractures and improving patient outcomes.
  • To discuss implementation challenges and propose a future strategy for ProFix.

Main Methods:

  • Literature review of studies on prophylactic fixation for proximal femur fractures.
  • Analysis of data on osteoporosis prevalence, fracture risk, and patient outcomes.
  • Examination of surgical techniques, anesthesia advancements, and healthcare economics.

Main Results:

  • ProFix offers a proactive approach to reduce fracture incidence and associated morbidity.
  • Potential benefits include enhanced patient mobility, reduced hospitalizations, and lower healthcare expenditures.
  • Minimally invasive techniques and improved anesthesia make ProFix increasingly feasible.

Conclusions:

  • Prophylactic fixation is a viable strategy to mitigate fracture risk in high-risk elderly individuals.
  • Early risk assessment and targeted intervention are crucial for effective implementation.
  • Further research and strategic planning are needed to optimize ProFix adoption.