Department of Orthopaedic Surgery, Johns Hopkins University/Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
Osteoporos Int. 2010 Dec;21(Suppl 4):S535-46. doi: 10.1007/s00198-010-1418-8. Epub 2010 Nov 6.
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.
低能量脆性骨折占老年患者骨折的>80%,随着人口老龄化,老年骨折手术在骨科工作量中占很大比例。老年患者的生理储备明显少于年轻患者,且合并症常见。即使进行了最佳治疗,其死亡率和发病率仍然很高。推荐多学科护理,包括早期骨科老年病学的介入,以预测和治疗并发症。本文探讨了针对这组具有挑战性患者的现代治疗策略,并根据现有最佳证据和相关卫生组织的建议,为手术前系统地准备和优化老年患者提供了指导。