Frakturen der oberen Extremität beim geriatrischen Patienten – Harmlose Monoverletzung oder Ende der Selbstständigkeit?

Abstract

In a prospective study 104 patients >or=65 years with distal radius fractures (DRF; n=52) and proximal forearm fractures (PHF; n=52) were followed up for a period of 4 months after injury. As an inception- cohort study, influence on treatment pattern was not part of the examination. A total of 53% of the DRF and 74% of the PHF patients underwent surgery. There were no significant changes in the ability of daily living management (IADL) with either fracture form. Functional outcome was better in PHF than DRF patients. PHF patients showed a high incidence in "fear of falling" throughout the whole study, whereas fear of falling rose significantly in DRF patients. 4% of DRF and 9.6% of PHF patients died during the observation period, while 6% of DRF and even 17% of PHF patients had to give up their own housekeeping. One third of both patient groups did not receive physiotherapy. In only 12% of DRF and 6% of PHF patients was osteoporosis treated. In both groups of patients there was a significant worsening in the ability of walking after injury, leading to two or more new falls in 24% of DRF and 28% of PHF patients.

Expected lifetime numbers and costs of fractures in postmenopausal women with and without osteoporosis in Germany: a discrete event simulation model

“…Therefore, the estimated fracture probabilities calculated from hospital discharge statistics and population data underestimate the “total” fracture probabilities, at least for clinical vertebral, humerus, pelvis and wrist fractures. To include these outpatient fracture cases in the total fracture probability, the fracture probabilities estimated based on hospital cases were divided by fracture specific and age-independent hospitalization probabilities from the literature (clinical vertebral [41,44,45], humerus [42], pelvis [43], wrist [42]) (see Additional file 1: A.3.a-b).…”

Open reduction and internal fixation versus casting for highly comminuted and intra-articular fractures of the distal radius (ORCHID): protocol for a randomized clinical multi-center trial

“…Baseline demographics, comorbidity and medication history of falls and fractures, fear of falling and the diagnosis of osteoporosis are recorded at this time. Falls, fracture falls, and fear of falling are variables associated with a generally poorer prognosis including higher mortality, and predictors of future falls in frail elderly patients [47-50]. …”

Umsetzung der Osteoporoseleitlinien in Orthopädie und Unfallchirurgie – Ergebnisse eines Expertenworkshops der DGOU

“…Frakturen der oberen Extremität [3]. Gerade die Frakturen der oberen Extremität werden hinsichtlich ihrer Auswirkung auf die Selbstständigkeit und Lebensqualität betroffener Patienten oft unterschätzt [6]. …”