Non-hip/non-vertebral fractures - How to treat best?

Best Pract Res Clin Rheumatol. 2019 Apr;33(2):236-263. doi: 10.1016/j.berh.2019.03.019. Epub 2019 May 16.

Abstract

Fractures of the extremities in the elderly constitute more than two-thirds of all fragility fractures befalling frail, osteoporotic and sarcopenic patients. Although treatment controversies abound, consensus exists. Upper extremity fractures hinder activities of daily living and are debilitating. Open fractures or displaced fractures will need surgical intervention. Wrist fractures treated operatively allow early use of the hand. Most pelvic fractures are treated conservatively. In the lower extremities, fractures of the long bones, tibia and femur need surgical intervention. Non-displaced fractures around the foot may be treated with immobilisation and avoidance of full weight-bearing. As a rule, fractures take four months for consolidation. Individually tailored solutions are needed for frail patients with comorbidities. Maintaining joint mobility and muscle strength preserves mobility and autonomy. Caring for extremities trauma is team work, involving family and health care providers. Prevention efforts are mandatory.

Keywords: Arthroplasty; Extremity fractures; Osteosynthesis; Rehabilitation.

Publication types

  • Review

MeSH terms

  • Activities of Daily Living
  • Aged
  • Arthroplasty / methods*
  • Female
  • Fracture Fixation / methods
  • Hip Fractures / physiopathology
  • Hip Fractures / surgery
  • Humans
  • Lower Extremity / injuries*
  • Male
  • Osteoporotic Fractures / surgery*
  • Spinal Fractures / physiopathology
  • Spinal Fractures / surgery
  • Upper Extremity / injuries*