External fixation in the elderly

Injury. 2015 Sep:46 Suppl 3:S7-S12. doi: 10.1016/S0020-1383(15)30004-8.

Abstract

Orthopaedic trauma is an increasingly common problem in geriatric patients. As demands of daily life and recreational activities are increasing in these patients, surgeons need to be able to manage geriatric fractures to achieve good functional results. Reduced bone quality in the elderly presents a considerable challenge and may preclude the use of established surgical stabilisation techniques that are performed in younger trauma patients. Furthermore, pre-existing medical conditions and considerable comorbidities in the elderly could complicate standard surgical procedures that younger patients would be offered. In this respect, application of external fixators represents a validated, minimally-invasive treatment opportunity. This review article summarises the use of external fixation in geriatric trauma patients for wrist fractures, proximal femoral fractures, pelvic fractures, and ankle fractures. Modern modifications, like pin coating with hydroxyapatite, and aspects of pin care will be discussed.

Keywords: Elderly; External fixation; Fracture; Geriatric; Pin infection.

Publication types

  • Review

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Bone Nails
  • External Fixators* / adverse effects
  • Female
  • Femoral Fractures / pathology
  • Femoral Fractures / surgery*
  • Fracture Fixation / adverse effects
  • Fracture Fixation / instrumentation*
  • Fracture Fixation / methods
  • Fracture Healing
  • Frail Elderly*
  • Humans
  • Male
  • Pelvic Bones / injuries*
  • Radius Fractures / pathology
  • Radius Fractures / surgery*
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / prevention & control
  • Treatment Outcome
  • Ulna Fractures / pathology
  • Ulna Fractures / surgery*