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Orthopaedic Trauma in the Elderly

  • William Min
  • Kenneth A. Egol
  • Joseph D. Zuckerman
Chapter

Abstract

Injuries to the musculoskeletal system in the elderly can be devastating. Many medical and social factors specific to older patients require special consideration when dealing with these injuries both acutely and throughout their rehabilitation. The geriatric segment of the population is rapidly growing and sustains a disproportionate number of fractures compared to others [1–3]. The specific goal of all orthopaedic care is to restore patient function to a preinjury level. Decreased bone stock, muscular weakness, systemic disease, and poor mentation are some challenges that make a return to independent living status difficult following such injuries. Immobilization and the use of devices to assist in ambulation (crutches, walkers, and wheelchairs) may require an elderly patient to be subjected to institutional care for an extended period of time. The following is an overview of the etiology, pathophysiology, and treatment considerations in treating geriatric patients with fractures and associated injuries.

Keywords

Rotator Cuff Injury Severity Score Femoral Neck Fracture Distal Radius Fracture Inferior Vena Cava Filter 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

The authors wish to acknowledge Drs. Frank A. Liporace and Kenneth J. Koval for their work in this chapter.

References

  1. 1.
    Stevens JA, Olson S (2000) Reducing falls and resulting hip fractures among older women. MMWR Recomm Rep 49(RR-2):3–12PubMedGoogle Scholar
  2. 2.
    Kannus P, Parkkari J, Sievanen H, Heinonen A, Vuori I, Jarvinen M (1996) Epidemiology of hip fractures. Bone 18(1 suppl):57S–63SPubMedCrossRefGoogle Scholar
  3. 3.
    Zuckerman JD (1996) Hip fracture. N Engl J Med 334:1519–1525PubMedCrossRefGoogle Scholar
  4. 4.
    Vu MQ, Weintraub N, Rubenstein LZ (2006) Falls in the nursing home: are they preventable? J Am Med Dir Assoc 7(3 Suppl):S53–S58, 52PubMedCrossRefGoogle Scholar
  5. 5.
    Epstein CD, Peerless J, Martin J, Malangoni M (2002) Oxygen transport and organ dysfunction in the older trauma patient. Heart Lung 31(5):315–326PubMedCrossRefGoogle Scholar
  6. 6.
    Johnson KD, Cadambi A, Seibert GB (1985) Incidence of adult respiratory distress syndrome in patients with multiple musculoskeletal injuries: effect of early operative stabilization of fractures. J Trauma 25(5):375–384PubMedCrossRefGoogle Scholar
  7. 7.
    Davis FM, Woolner DF, Frampton C, Wikinson A, Grant A, Harrison RT, Roberts MTS, Thakada R (1987) Prospective, multi-centre trial of mortality following general or spinal anaesthesia for hip fracture surgery in the elderly. Br J Anaesth 59:1080–1088PubMedCrossRefGoogle Scholar
  8. 8.
    Valentin N, Lomholt B, Jensen JS, Hejgaard N, Kreiner S (1986) Spinal or general anaesthesia for surgery of the fractured hip? Br J Anaesth 58:284–291PubMedCrossRefGoogle Scholar
  9. 9.
    Parker MJ, Handoll HH, Griffiths R (2004) Anaesthesia for hip fracture surgery in adults. Cochrane Database Syst Rev (4):CD000521Google Scholar
  10. 10.
    Covert CR, Fox GS (1989) Anaesthesia for hip surgery in the elderly. Can J Anaesth 36(3 Pt 1):311–319PubMedGoogle Scholar
  11. 11.
    Loder RT (1988) The influence of diabetes on the healing of closed fractures. Clin Orthop 232:210–216PubMedGoogle Scholar
  12. 12.
    Chaudhary SB, Liporace FA, Gandhi A, Donley BG, Pinzur MS, Lin SS (2008) Complications of ankle fracture in patient with diabetes. J Am Acad Orthop Surg 16(3):159–170PubMedGoogle Scholar
  13. 13.
    Geerts WM, Pineo GF, Heit JA, Bergqvist D, Lassen MR, Colwell CW, Ray JG (2004) Prevention of venous thromboembolism: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 126:338S–411SPubMedCrossRefGoogle Scholar
  14. 14.
    Caprini JA, Arcelus JI, Maksimovic D, Glase CJ, Sarayba JG, Hathaway K (2002) Thrombosis prophylaxis in orthopedic surgery: current clinical considerations. J South Orthop Assoc 11(4):190–196PubMedGoogle Scholar
  15. 15.
    El Kouri D, Chevalet P, Hamidou M, Lemant J, Potel G (1999) Treatment of venous thromboembolic disease in the elderly. J Mal Vasc 24(3):183–188PubMedGoogle Scholar
  16. 16.
    Aaron JE, Gallagher JC, Anderson J et al (1974) Frequency of osteomalacia and osteoporosis in fractures of the proximal femur. Lancet 1:229–233PubMedCrossRefGoogle Scholar
  17. 17.
    Lane JM, Vigorita VJ (1983) Osteoporosis. J Bone Joint Surg 65A:274–278Google Scholar
  18. 18.
    Gehrig L, Lane J, O’Connor MI (2008) Osteoporosis: management and treatment strategies for orthopaedic surgeons. J Bone Joint Surg Am 90(6):1362–1374PubMedGoogle Scholar
  19. 19.
    Heiss G, Wallace R, Anderson GL, Aragaki A, Beresford SAA, Brzyski R, Chlebowski RT, Gass M, LaCroix A, Manson JE, Prentice RL, Rossouw J, Stefanick ML, for the WHI Investigators (2008) Health risks and benefits 3 years after stopping randomized treatment with estrogen and progestin. JAMA 299(9):1036–1045PubMedCrossRefGoogle Scholar
  20. 20.
    Jenkins DHR, Roberts JG, Webster D, Williams EO (1973) Osteomalacia in elderly patients with fracture of the femoral neck: a clinico-pathological study. J Bone Joint Surg 55B:575–580Google Scholar
  21. 21.
    Wilton TJ, Hosking DJ, Pawley E, Stevens A, Harvey L (1987) Osteomalacia and femoral neck fractures in the elderly. J Bone Joint Surg 69B:388–390Google Scholar
  22. 22.
    Moroni A, Hoang-Kim A, Lio V, Giannini S (2006) Current augmentation fixation techniques for the osteoporotic patient. Scand J Surg 95(2):103–109PubMedGoogle Scholar
  23. 23.
    Fulkerson E, Egol KA, Kubiak EN, Liporace F, Kummer FJ, Koval KJ (2006) Fixation of diaphyseal fractures with a segmental defect: a biomechanical comparison of locked and conventional plating techniques. J Trauma 60(4):830–835PubMedCrossRefGoogle Scholar
  24. 24.
    Haidukewych GJ, Ricci W (2008) Locked plating in orthopaedic trauma: a clinical update. J Am Acad Orthop Surg 16(6):347–355PubMedGoogle Scholar
  25. 25.
    Osteoporosis: current evaluation and treatment. http://healthlink.mcw.edu/article/983292666.html. Accessed 27 Dec 2008
  26. 26.
    Crandall C (2002) Parathyroid hormone for treatment of osteoporosis. Arch Intern Med 162:2297–2309PubMedCrossRefGoogle Scholar
  27. 27.
    Hesp R, Hulme P, Williams D, Reeve J (1981) The relationship between changes in femoral bone density and calcium balance in patients with involutional osteoporosis treated with human parathyroid hormone fragment hPTH (1-34). Metab Bone Dis Relat Res 2:331–334CrossRefGoogle Scholar
  28. 28.
    Koval KJ, Skovron ML, Aharonoff GB, Meadows SE, Zuckerman JD (1995) Ambulatory ability after hip fracture: a prospective study in geriatric patients. Clin Orthop Relat Res 310:150–159PubMedGoogle Scholar
  29. 29.
    Aharonoff GB, Koval KJ, Skovron ML, Zuckerman JD (1997) Hip fractures in the elderly: predictors of one year mortality. J Orthop Trauma 11:162–165PubMedCrossRefGoogle Scholar
  30. 30.
    Zuckerman JD, Skovron ML, Koval KJ, Aharanoff GB, Frankel VH (1995) Postoperative complications and mortality associated with operative delay in older patients who have a fracture of the hip. J Bone Joint Surg 77A:1551–1556Google Scholar
  31. 31.
    Al-Ani AN, Samuelsson B, Tidermark J, Norling A, Ekstrom W, Cederholm T, Hedstrom M (2008) Early operation on patients with a hip fracture improved the ability to return to independent living. A prospective study of 850 patients. J Bone Joint Surg Am 90(7):1436–1442PubMedCrossRefGoogle Scholar
  32. 32.
    Hagino T, Sato E, Tonotsuka H, Ochiai S, Tokai M, Hamada Y (2006) Prediction of ambulation prognosis in the elderly after hip fracture. Int Orthop 30(5):315–319PubMedCrossRefGoogle Scholar
  33. 33.
    Perdue PW, Watts DD, Kaufmann CR, Trask AL (1998) Differences in mortality between elderly and younger adult trauma patients: geriatric status increases risk of delayed death. J Trauma 45(4):805–810PubMedCrossRefGoogle Scholar
  34. 34.
    Tornetta P III, Mostafavi H, Riina J, Turen C, Reimer B, Levine B, Behrens F, Geller J, Ritter C, Homel P (1999) Morbidity and mortality in elderly trauma patients. J Trauma 46(4):702–706PubMedCrossRefGoogle Scholar
  35. 35.
    Gallagher SF, Williams B, Gomez C, DesJardins C, Swan S, Durham RM, Flint LM (2003) The role of cardiac morbidity in short- and long-term mortality in injured older patients who survive initial resuscitation. Am J Surg 185(2):131–134PubMedCrossRefGoogle Scholar
  36. 36.
    Moran CG, Wenn RT, Sikand M, Taylor AM (2005) Early mortality after hip fracture: is delay before surgery important? J Bone Joint Surg Am 87(3):483–489PubMedCrossRefGoogle Scholar
  37. 37.
    Meldon SW, Reilly M, Drew BL, Mancuso C, Fallow W Jr (2002) Trauma in the very elderly: a community-based study of outcomes at trauma and nontrauma centers. J Trauma 52(1):79–84PubMedCrossRefGoogle Scholar
  38. 38.
    Sugimoto K, Aruga T, Hirata M, Shindo M (1999) Geriatric trauma patients at a suburban level-I trauma center in Japan. Prehosp Disaster Med 14(3):186–190PubMedGoogle Scholar
  39. 39.
    Brody JA (1985) Commentary: prospects for an ageing population. Nature 315:463–466PubMedCrossRefGoogle Scholar
  40. 40.
    Frandsen PA, Kruse T (1983) Hip fractures in the county of Funen, Denmark. Implications of demographic aging and changes in incidence rates. Acta Orthop Scand 54:681–686PubMedCrossRefGoogle Scholar
  41. 41.
    Praemer A, Furner S, Rice D (eds) (1992) Musculoskeletal conditions in the United States. The American Academy of Orthopaedic Surgeons, Park Ridge, ILGoogle Scholar
  42. 42.
    Greenspan SL et al (1994) Fall severity and bone mineral density as risk factors for hip fractures in ambulatory elderly. JAMA 271:128–133PubMedCrossRefGoogle Scholar
  43. 43.
    Hinton RY, Lennox DW, Ebert FR, Jacobsen SJ, Smith GS (1995) Relative rates of fracture of the hip in the United States: geographic, sex, and age variations. J Bone Joint Surg 77A:695–702Google Scholar
  44. 44.
    Hinton RY, Smith GS (1993) The association of age, race, and sex with the location of proximal femoral fractures in the elderly. J Bone Joint Surg 75A:752–759Google Scholar
  45. 45.
    Garraway WM, Stauffer RN, Kurland LT, O’Falba WM (1979) Limb fractures in a defined population. I. Frequency and distribution. Mayo Clin Proc 54:701–707PubMedGoogle Scholar
  46. 46.
    Johnell O, Sernbo I (1986) Health and social status in patients with hip fractures and controls. Age Ageing 15:285–291PubMedCrossRefGoogle Scholar
  47. 47.
    Uden G, Nilsson B (1986) Hip fracture frequent in hospital. Acta Orthop Scand 57:428–430PubMedCrossRefGoogle Scholar
  48. 48.
    Gallagher JC, Melton LJ, Riggs BL, Bergtrath E (1980) Epidemiology of fractures of the proximal femur in Rochester Minnesota. Clin Orthop 150:163–167PubMedGoogle Scholar
  49. 49.
    Bonnaire F, Schaefer DJ, Kuner EH (1998) Hemarthrosis and hip joint pressure in femoral neck fractures. Clin Orthop Relat Res 353:148–155PubMedCrossRefGoogle Scholar
  50. 50.
    Koval KJ, Oh CK, Egol KA (2008) Does a traction-internal rotation radiograph help to better evaluate fractures of the proximal femur? Bull NYU Hosp Jt Dis 66(2):102–106PubMedGoogle Scholar
  51. 51.
    Susarla A, Kubiak EN, Egol KA, Karp A, Zuckerman JD, Koval KJ (2006) Predictive value of preoperative arterial blood glass evaluation for geriatric patients with hip fractures. Am J Orthop 35(2):74–78PubMedGoogle Scholar
  52. 52.
    Lubovsky O, Liebergall M, Mattan Y, Weil Y, Mosheiff R (2005) Early diagnosis of occult hip fractures MRI versus CT scan. Injury 36(6):788–792PubMedCrossRefGoogle Scholar
  53. 53.
    Rizzo PF, Gould ES, Lyden JP, Asnis SE (1993) Diagnosis of occult fractures about the hip. Magnetic resonance imaging compared with bone-scanning. J Bone Joint Surg 75A:395–401Google Scholar
  54. 54.
    Parker MJ et al (1992) Cost-benefit analysis of hip fracture treatment. J Bone Joint Surg 74B(2):261–264Google Scholar
  55. 55.
    Colwell CW, Spiro TE, Trowbridge AA et al (1994) Use of enoxaparin, a low-molecular-weight heparin for the prevention of deep venous thrombosis after elective hip replacement. A clinical trial comparing efficacy and safety. Enoxaparin Clinical Trial Group. J Bone Joint Surg 76A:3–14Google Scholar
  56. 56.
    Geerts WH, Jay RM, Code KI et al (1996) A comparison of ­low-dose heparin with low-molecular-weight heparin as prophylaxis against venous thromboembolism after major trauma. N Engl J Med 335:701–707PubMedCrossRefGoogle Scholar
  57. 57.
    Hull R, Delmore T, Genotn E et al (1979) Warfarin sodium versus low-dose heparin in the long-term treatment of venous thrombosis. N Engl J Med 301(16):855–858PubMedCrossRefGoogle Scholar
  58. 58.
    Merli GJ (1993) Update deep venous thrombosis and pulmonary embolism prophylaxis in orthopaedic surgery. Med Clin North Am 77(2):397–412PubMedGoogle Scholar
  59. 59.
    Kearon C (2003) Duration of venous thromboembolism prophylaxis after surgery. Chest 124:386S–392SPubMedCrossRefGoogle Scholar
  60. 60.
    Sexson SB, Lehner JT (1988) Factors affecting hip fracture mortality. J Orthop Trauma 1:298–305CrossRefGoogle Scholar
  61. 61.
    White BL, Fischer WD, Lauren C (1987) Rates of mortality for elderly patients after fracture of the hip in the 1980s. J Bone Joint Surg 69A:1335–1340Google Scholar
  62. 62.
    Bredahl C, Nyholm B, Hindsholm FB, Mortensen JS, Olesen AS (1992) Mortality after hip fracture: results of operation within 12 h of admission. Injury 23:83–86PubMedCrossRefGoogle Scholar
  63. 63.
    Office for National Statistics (2008) http://www.statistics.gov.uk. Accessed 9 Sept 2008
  64. 64.
    Kenzora JE, McCarthy RE, Lowell JD, Sledge CB (1984) Hip fracture mortality: relation to age, treatment, preoperative illness, time of surgery and complications. Clin Orthop 186:45–56PubMedGoogle Scholar
  65. 65.
    Frankel VH, Burstein AH, Lygre L, Brown RH (1971) The telltale nail. J Bone Joint Surg 53A:1232Google Scholar
  66. 66.
    Koval K, Friend KD, Aharanoff GB, Zuckerman JD (1996) Weightbearing after hip fracture: a prospective series of 596 geriatric hip fracture patients. J Orthop Trauma 10(8):526–530PubMedCrossRefGoogle Scholar
  67. 67.
    Koval K, Sala DA, Kummer FJ, Zuckerman JD (1988) Postoperative weightbearing after a fracture of the femoral neck or an intertrochanteric fracture. J Bone Joint Surg Am 80(3):352–356Google Scholar
  68. 68.
    Barnes R, Brown JT, Garden RS, Nicoll EA (1976) Subcapital fractures of the femur. A prospective review. J Bone Joint Surg 58B(1):2–24Google Scholar
  69. 69.
    Schmidt AH, Swiontkowski MF (2002) Femoral neck fractures. Orthop Clin North Am 33(1):97–111PubMedCrossRefGoogle Scholar
  70. 70.
    Cobb AG, Gibson PH (1986) Screw fixation of subcapital fractures of the femur: a better method of treatment. Injury 17:259–264PubMedCrossRefGoogle Scholar
  71. 71.
    Garden RS (1971) Malreduction and avascular necrosis in subcapital fractures of the femur. J Bone Joint Surg Br 53B:183–197Google Scholar
  72. 72.
    Stromqvist B, Hansson LI, Nilsson LT et al (1987) Hook-pin fixation in femoral neck fractures: a two-year follow-up study of 300 cases. Clin Orthop 218:58–62PubMedGoogle Scholar
  73. 73.
    Bentley G (1980) Treatment of non-displaced fractures of the femoral neck. Clin Orthop 152:93–101PubMedGoogle Scholar
  74. 74.
    Shuqiang M, Kunzheng W, Zhichao T, Mingyu Z, Wei W (2006) Outcome of non-operative management in Garden I femoral neck fractures. Injury 37(10):974–978PubMedCrossRefGoogle Scholar
  75. 75.
    Bhandari M, Devereaux PJ, Swiontkowski MF, Tornetta P III, Obremskey W, Koval KJ, Nork S, Sprague S, Schemitsch EH, Guyatt GH (2003) Internal fixation compared with arthroplasty for displaced fractures of the femoral neck. A meta-analysis. J Bone Joint Surg Am 85-A(9):1673–1681PubMedGoogle Scholar
  76. 76.
    Calder SJ, Anderson GH, Jagger C, Harper WM, Gregg PJ (1996) Unipolar or bipolar prosthesis for displaced intracapsular hip fractures in octogenarians. J Bone Joint Surg 78B:391–394Google Scholar
  77. 77.
    Blomfeldt R, Tornkvist H, Eriksson K, Soderqvist A, Ponzer S, Tidemark J (2007) A randomized controlled trial comparing bipolar hemiarthroplasty with total hip replacement for displaced intracapsular fractures of the femoral neck in the elderly patients. J Bone Joint Surg Br 89(2):160–165PubMedCrossRefGoogle Scholar
  78. 78.
    Evans EM (1949) The treatment of trochanteric fractures of the femur. J Bone Joint Surg 31B:190–203Google Scholar
  79. 79.
    Koval KJ, Zuckerman JD (1994) Hip fractures: II. Evaluation and treatment of intertrochanteric fractures. J Am Acad Orthop Surg 2:150–156PubMedGoogle Scholar
  80. 80.
    Michelson JD, Myers A, Jinnah R et al (1995) Epidemiology of hip fractures among the elderly: risk factors for fracture type. Clin Orthop 311:129–135PubMedGoogle Scholar
  81. 81.
    Kyle RF, Cabanela ME, Russell TA et al (1995) Fractures of the proximal part of the femur. Review. Instr Course Lect 44:227–253PubMedGoogle Scholar
  82. 82.
    Tencer AF, Calhoun J, Miller BB (1985) Stiffness of subtrochanteric fracture of the femur stabilized using a Richards interlocking intramedullary rod or Richards AMBI. Orthop Biomech Lab Report #002. Richards Medical Co., MemphisGoogle Scholar
  83. 83.
    Tencer AF, Johnson KD, Johnston DWC, Gill K (1984) A biomechanical comparison of various methods of stabilization of subtrochanteric fractures of the femur. J Orthop Res 2:297–305PubMedCrossRefGoogle Scholar
  84. 84.
    Allis OH (1891) Fracture in the upper third of the femur exclusive of the neck. Med News 59:585–589Google Scholar
  85. 85.
    Miedel R, Ponzer S, Tornkvist H, Soderqvist A, Tidermark J (2005) The standard Gamma nail or the Medoff sliding plate for unstable trochanteric and subtrochanteric fractures. A randomized, controlled trial. J Bone Joint Surg Br 87(1):68–75PubMedGoogle Scholar
  86. 86.
    Haynes RC, Poll RG, Miles AW, Weston RB (1997) An experimental study of the failure modes of the Gamma Locking Nail and AO Dynamic Hip Screw under static loading: a cadaveric study. Med Eng Phys 19(5):446–453PubMedCrossRefGoogle Scholar
  87. 87.
    Lauge-Hansen N (1948) Fractures of the ankle. Analytic historic survey as basis of new experimental roentgenologic and clinical investigations. Arch Surg 56:259–317CrossRefGoogle Scholar
  88. 88.
    Lauge-Hansen N (1950) Fractures of the ankle II. Combined experimental-surgical and experimental roentgenologic investigation. Arch Surg 60:957–985PubMedCrossRefGoogle Scholar
  89. 89.
    Ramsey P, Hamilton W (1976) Changes in tibiotalar area of contact caused by lateral talar shift. J Bone Joint Surg 58A:356–357Google Scholar
  90. 90.
    Keene JS, Lange RH (1986) Diagnostic dilemmas in foot and ankle injuries. JAMA 256:247–251PubMedCrossRefGoogle Scholar
  91. 91.
    Beauchamp CG, Clay NR, Thexton PW (1983) Displaced ankle fractures in patients over 50 years of age. J Bone Joint Surg 63B:329–332Google Scholar
  92. 92.
    Ali MS, McLaren AN, Routholamin E, O’Connor BT (1987) Ankle fractures in the elderly: nonoperative or operative treatment. J Orthop Trauma 1:275–280PubMedCrossRefGoogle Scholar
  93. 93.
    Horak J, Nilsson BE (1975) Epidemiology of fractures of the upper end of the humerus. Clin Orthop Relat Res 112:250–253PubMedCrossRefGoogle Scholar
  94. 94.
    Simon JA, Puopolo SM, Capla EL, Egol KA, Zuckerman JD, Koval KJ (2004) Accuracy of the axillary projection to determine fracture angulation of the proximal humerus. Orthopedics 27(2):205–207PubMedGoogle Scholar
  95. 95.
    McLaurin TM (2004) Proximal humerus fractures in the elderly are we operating on too many? Bull Hosp Jt Dis 62(1–2):24–32PubMedGoogle Scholar
  96. 96.
    Koval K, Gallagher MA, Marsicano JG, Cuomo F, McShinway A, Zuckerman JD (1997) Functional outcome after minimally displaced fracture of the proximal part of the humerus. J Bone Joint Surg 79A:203–207Google Scholar
  97. 97.
    Court-Brown CM, Garg A, Mc Queen MM (2001) The translated two-part fracture of the proximal humerus: Epidemiology and outcome in the older patient. J Bone Joint Surg Br 83B:799–804CrossRefGoogle Scholar
  98. 98.
    Lefevre-Colau MM, Babinet A, Fayad F, Fermanian J, Anract P, Roren A, Kansao J, Revel M, Poiraudeau S (2007) Immediate mobilization compared with conventional immobilization for the impact nonoperatively treated proximal humeral fracture. A randomized control trial. J Bone Joint Surg Am 89(12):2582–2590PubMedCrossRefGoogle Scholar
  99. 99.
    Koval KJ, Gallagher MA, Marsicano JG, Cuomo F, McShinawy A, Zuckerman JD (1997) Functional outcome after minimally displaced fractures of the proximal part of the humerus. J Bone Joint Surg Am 79-A:203–207Google Scholar
  100. 100.
    Bosch U, Skutek M, Fremerey RW, Tscherne H (1998) Outcome after primary and secondary hemiarthroplasty in elderly patients with fractures of the proximal humerus. J Should Elbow Surg 7:479–484CrossRefGoogle Scholar
  101. 101.
    Goldman R, Koval KJ, Cuomo F, Gallagher MA, Zuckerman JD (1995) Functional outcome after humeral head replacement for acute three- and four-part proximal humeral fractures. J Should Elbow Surg 4(2):81–86CrossRefGoogle Scholar
  102. 102.
    Prakash U, McGurty DW, Dent JA (2002) Hemiarthroplasty for severe fractures of the proximal humerus. J Shoulder Elbow Surg 11(5):428–430PubMedCrossRefGoogle Scholar
  103. 103.
    Tejwani NC, Liporace F, Walsh M, France MA, Zuckerman JD, Egol KA (2008) Functional outcome following one-part proximal humeral fractures: a prospective study. J Shoulder Elbow Surg 17(2):216–219PubMedCrossRefGoogle Scholar
  104. 104.
    Robinson CM, Page RS, Hill RM, Sanders DL, Court-Brown CM, Wakefield AE (2003) Primary hemiarthroplasty for treatment of proximal humeral fractures. J Bone Joint Surg Am 85-A(7):1215–1223PubMedGoogle Scholar
  105. 105.
    Mighell MA, Kolm GP, Collinge CA, Frankle MA (2003) Outcomes of hemiarthroplasty for fractures of the proximal humerus. J Shoulder Elbow Surg 12(6):569–577PubMedCrossRefGoogle Scholar
  106. 106.
    Alffram P, Bauer G (1962) Epidemiology of fractures of the forearm. J Bone Joint Surg 44A:105–114Google Scholar
  107. 107.
    Fryckman G (1967) Fractures of the distal radius including sequelae. Acta Orthop Scand Suppl 180:1–153Google Scholar
  108. 108.
    Park MJ, Cooney WP III, Hahn ME, Looi KP, An KN (2002) The effects of dorsally angulated distal radius fractures on carpal kinematics. J Hand Surg Am 27(2):223–232PubMedCrossRefGoogle Scholar
  109. 109.
    Lafontaine M, Hardy D, Delince P (1989) Stability assessment of distal radius fractures. Injury 20:208–210PubMedCrossRefGoogle Scholar
  110. 110.
    Nesbitt KS, Failla JM, Les C (2004) Assessment of instability factors in adult distal radius fractures. J Hand Surg Am 29A:1128–1138CrossRefGoogle Scholar
  111. 111.
    Orbay JL, Fernandez DL (2004) Volar fixed-angle plate fixation for unstable distal radius fractures in the elderly patient. J Hand Surg Am 29(A):96–102PubMedCrossRefGoogle Scholar
  112. 112.
    Gehrmann SV, Windolf J, Kaufmann RA (2008) Distal radius fracture management in elderly patients: a literature review. J Hand Surg Am 33(3):421–429PubMedCrossRefGoogle Scholar
  113. 113.
    Colles A (1814) On the fracture of the carpal extremity of the radius. Edinb Med Surg J 10:182–186Google Scholar
  114. 114.
    Villar RN, Marsh D, Righton N, Greatorex RA (1987) Three years after Colles’ fracture: a prospective review. J Bone Joint Surg 69B(4):635–638Google Scholar
  115. 115.
    ACS (2008) What is bone metastasis? http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_Is_bone_metastasis_66.asp. Accessed 16 Dec 2008
  116. 116.
    Bhardwaj S, Holland JF (1982) Chemotherapy of metastatic cancer in bone. Clin Orthop Relat Res 169:34Google Scholar
  117. 117.
    Harrington KD (1986) Impending pathological fractures from metastatic malignancy: evaluation and management. Instr Course Lect 35:357–381PubMedGoogle Scholar
  118. 118.
    Harrington KD, Sim FH, Enis JE et al (1976) Methylmethacrylate as an adjunct in internal fixation of pathological fractures. J Bone Joint Surg 58A:1047–1055Google Scholar
  119. 119.
    Kauh B, Polak T, Hazelett S, Hua K, Allen K (2005) A pilot study: post-acute geriatric rehabilitation versus usual care in skilled nursing facilities. J Am Med Dir Assoc 6(5):321–326PubMedCrossRefGoogle Scholar
  120. 120.
    Logters T, Hakimi M, Linhart W, Kaiser T, Briem D, Rueger J, Windolf J (2008) Early interdisciplinary geriatric rehabilitation after hip fracture: effective concept or just transfer of costs? Unfallchirurg 111(9):719–726PubMedCrossRefGoogle Scholar
  121. 121.
    Koval KJ, Aharonoff GB, Su ET, Zuckerman JD (1998) Effect of acute inpatient rehabilitation on outcome after fracture of the femoral neck or intertrochanteric fracture. J Bone Joint Surg Am 80(3):357–364PubMedGoogle Scholar
  122. 122.
    Ruchlin HS, Elkin EB, Allegrante JP (2001) The economic impact of a multifactorial intervention to improve post-operative rehabilitation of hip fractures. Arthritis Rheum 45(5):446–452PubMedCrossRefGoogle Scholar
  123. 123.
    Ennis RS (2008) Deep venous thrombosis prophylaxis in orthopedic surgery. http://emedicine.medscape.com/article/1268573-overview#Table2. Accessed 16 Dec 2008

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • William Min
    • 1
  • Kenneth A. Egol
  • Joseph D. Zuckerman
  1. 1.Department of Orthopaedic SurgeryNYU Hospital for Joint DiseasesNew YorkUSA

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