Kuner E H, Schaefer D J
Abteilung Unfallchirurgie, Albert-Ludwigs-Universität Freiburg.
Orthopade. 1994 Feb;23(1):21-31.
The frequency of fractures in the elderly has risen dramatically and will increase further in the future. This is partly a socio-economic problem and is familiar both to surgeons and to the general population. Fractures in such patients have clinical and pathomechanical implications, with unassociated conditions needing treatment. It is necessary to standardize treatment, including operative procedures, which can be performed in every hospital. The therapeutic measures available involve close cooperation between the surgeon, the geriatrician and ancillary workers. For some fractures in the elderly there are already operative procedures that ensure efficient rehabilitation and reintegration into society. Osteoporosis can make osteosynthesis problematic. Radiological measurements of bone density are of diagnostic rather than therapeutic value. Operative procedures and their effectiveness in common fractures in the elderly (hip, distal radius, shoulder) are discussed. It is stated that surgical treatment is very important in mastering this challenge, but other aspects, particularly ethical considerations, are paramount.
老年人骨折的发生率急剧上升,且未来还会进一步增加。这在一定程度上是一个社会经济问题,外科医生和普通大众对此都不陌生。这类患者的骨折具有临床和病理力学影响,还存在需要治疗的相关病症。有必要规范治疗,包括手术操作,这些操作应能在每家医院开展。现有的治疗措施需要外科医生、老年病科医生和辅助工作人员密切合作。对于老年人的某些骨折,已有能确保有效康复并重新融入社会的手术操作。骨质疏松会使骨合成出现问题。骨密度的放射学测量具有诊断价值而非治疗价值。本文讨论了老年人常见骨折(髋部、桡骨远端、肩部)的手术操作及其有效性。文中指出,手术治疗对于应对这一挑战非常重要,但其他方面,尤其是伦理考量,至关重要。