1. The outcome of tibial diaphyseal fractures in the elderly.
- Author
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Clement ND, Beauchamp NJ, Duckworth AD, McQueen MM, and Court-Brown CM
- Subjects
- Aged, Aged, 80 and over, Bone Nails statistics & numerical data, Casts, Surgical statistics & numerical data, Compartment Syndromes etiology, Compartment Syndromes mortality, Diaphyses injuries, Female, Fractures, Closed etiology, Fractures, Closed mortality, Fractures, Closed surgery, Fractures, Open etiology, Fractures, Open mortality, Fractures, Open surgery, Humans, Incidence, Male, Prognosis, Prospective Studies, Scotland epidemiology, Tibial Fractures etiology, Tibial Fractures surgery, Tibial Fractures mortality
- Abstract
We describe the outcome of tibial diaphyseal fractures in the elderly (≥ 65 years of age). We prospectively followed 233 fractures in 225 elderly patients over a minimum ten-year period. Demographic and descriptive data were acquired from a prospective trauma database. Mortality status was obtained from the General Register Office database for Scotland. Diaphyseal fractures of the tibia in the elderly occurred predominantly in women (73%) and after a fall (61%). During the study period the incidence of these fractures decreased, nearly halving in number. The 120-day and one-year unadjusted mortality rates were 17% and 27%, respectively, and were significantly greater in patients with an open fracture (p < 0.001). The overall standardised mortality ratio (SMR) was significantly increased (SMR 4.4, p < 0.001) relative to the population at risk, and was greatest for elderly women (SMR 8.1, p < 0.001). These frailer patients had more severe injuries, with an increased rate of open fractures (30%), and suffered a greater rate of nonunion (10%). Tibial diaphyseal fractures in the elderly are most common in women after a fall, are more likely to be open than in the rest of the population, and are associated with a high incidence of nonunion and mortality.
- Published
- 2013
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