Operative treatment of nonunions in the elderly: Clinical and radiographic outcomes in patients at minimum 75 years of age. Review uri icon

Overview

abstract

  • BACKGROUND: Limited information exists on nonunion treatment in the elderly. This retrospective study evaluates whether results of operative treatment of nonunion of the humerus or femur in patients aged ≥ 75 years are comparable to those in younger patients. METHODS: We identified patients age ≥ 75 years with a nonunion of humerus or femur treated with open reduction and internal fixation. The Non-Union Scoring System was calculated. Complications, clinical outcome, and radiographic findings were assessed. Primary endpoint was nonunion healing. A literature review compared time to healing of humeral and femoral nonunion in younger populations. RESULTS: We identified 45 patients treated for a nonunion of humerus or femur with > 12 months follow-up. Median age was 79 years (range 75-96). Median time to presentation was 12 months (range 4-127) after injury, median number of prior surgeries was 1 (range 0-4). Union rate was 100%, with median time to union 6 months (range 2-42). Six patients underwent revision for persistent nonunion and healed without further complications. CONCLUSIONS: Using a protocol of debridement, alignment, compression, stable fixation, bone grafting and early motion, patients aged 75 years or older can reliably achieve healing when faced with a nonunion of the humerus or femur. LEVEL OF EVIDENCE: IV.

publication date

  • December 20, 2022

Research

keywords

  • Fractures, Ununited

Identity

PubMed Central ID

  • PMC9764700

Scopus Document Identifier

  • 85144298077

Digital Object Identifier (DOI)

  • 10.1186/s12877-022-03670-8

PubMed ID

  • 36539691

Additional Document Info

volume

  • 22

issue

  • 1