gms | German Medical Science

Objectives: Goal is to present the results of the first 2 years of our Orthogeriatric Fracture Unit. All patients (age >70 with 2 comorbidities or age >80) (n=228 with 234 fractures) with a geriatric fracture with a minimum 1-year follow-up, were included.

Methods: We retrospectively analyzed the records of all patients included. End point was the out-patient consultation 1 year after surgery or their relatives or their care facility were contacted.

We assessed the 30 day- and 1 year mortality, the complications (rated according to clavien-dindo), time to surgery, length of stay and rate of re-hospitalization (same reason or other) for surgical outcome. As additional outcome we assessed discharge location, pain, functional independence measure (FIM) at discharge, rate of specific antiosteoporotic treatment, rate of delirium and decubitus.

Result: 7 proximal humerus, 1 humerus shaft, 5 olecranon, 5 forearm, 10 radius fractures and 1 acetabulum fracture were treated with open reduction and internal fixation (ORIF). 78 pertrochanteric (77 closed reduction and internal fixation (CRIF); 8 DHS, 48 TFNA- and 9 Y-nails and 1 total hip arthroplasty (THA)), 72 femur neck fractures (7 CRIF with 3 cannulated screws and 4 DHS, 40 hemiarthroplasties and 25 THAs), 20 periprosthetic (17 ORIF and 3 implant exchange), 4 periimplant fractures (3 implant exchange and 1 ORIF), 15 subtrochanteric/femur shaft fractures (either ORIF or CRIF long nail), 4 distal femur, 2 patella, 2 tibiaplateau and 8 ankle joints.

Mean age at operation was 85.3 (range 68–99) years. One patient with age 68 was included due to the geriatric comorbidities although not qualifying by age for the orthogeriatric program. Mean length of stay was 15.8 (range 2–43) days. Mean time to surgery was 18,8 (0–216) hours for the group of patients requiring no further preoperative therapy or preparations (adjustment of coagulation, specialist consultation, shipment of special equipment, intensive care).

214 Patients were discharged, 14 (6,5%) home, 139 (65%) rehabilitation, 35 (6.4%) back to nursing home, 20 (9,3%) newly admitted to nursing home.

121 (53,1%) had no complications, 35 (15,4%) grade 1, 33 (14,5%) grade 2, 18 (7,9%) grade 3, 4 (7,1%) grade 4, 14 (6,1%) grade 5.

Mean rise of the FIM from admittance to discharge was 17.3 (-11–72).

With our newly started Orthogeriatric Fracture Unit we could match the data provided by literature. Certainly we need to further improve our patient pathways and processes, in order to improve our results.