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How to optimize patients for geriatric fracture surgery

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Abstract

Low-energy fragility fractures account for >80% of fractures in elderly patients, and with aging populations, geriatric fracture surgery makes up a substantial proportion of the orthopedic workload. Elderly patients have markedly less physiologic reserve than do younger patients, and comorbidity is common. Even with optimal care, the risk of mortality and morbidity remains high. Multidisciplinary care, including early orthogeriatric input, is recommended to anticipate and treat complications. This article explores modern treatment strategies for this challenging group of patients and provides guidance for systematically preparing and optimizing elderly patients before surgery, based on best available current evidence and recommendations by relevant health organizations.

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Conflicts of interest

Dr. Stephen L. Kates is a speaker with Eli Lilly & Co. and has received a research grant from Synthes, Inc. The remaining authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Johns Hopkins University/Johns Hopkins Bayview Medical Center, Baltimore, MD, USA

    D. Marsland & S. C. Mears

  2. Division of Geriatric Medicine, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, Baltimore, MD, USA

    P. L. Colvin

  3. Department of Orthopaedic Surgery, University of Rochester, Rochester, NY, USA

    S. L. Kates

  4. c/o Elaine P. Henze, BJ, ELS, Medical Editor and Director, Editorial Services, Department of Orthopaedic Surgery, Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., #A665, Baltimore, MD, 21224-2780, USA

    S. C. Mears

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Marsland, D., Colvin, P.L., Mears, S.C. et al. How to optimize patients for geriatric fracture surgery. Osteoporos Int 21 (Suppl 4), 535–546 (2010). https://doi.org/10.1007/s00198-010-1418-8

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