The Elderly Osteoporotic Patient

Abstract

Distal radius fractures are one of the most frequent fractures in the elderly. With the growing population of older people, the incidence of distal radius fractures will increase as well. The treatment of those fractures, as well as means to prevent them, has become of great interest. The two most important factors of prevention are prevention of falls and treatment of osteoporosis, as those are the two strongest predictors for sustaining a distal radius fracture in this age group. Osteoporosis does not only increase the risk of a fracture but also places a challenge in the treatment as it contributes to delayed healing, secondary displacement and problems regarding choice of osteofixations. With a growing age, there is a general increase in co-morbidity, and the functional demands tend to be lowered. Nevertheless, increased number of today’s elderly is remaining active, and the choice of treatment requires individual evaluation. Even though there is evidence showing correlation between anatomical outcome and functional outcome in younger patients, this does not seem to be the case for the elderly. This is the main reason why the choice of treatment for this age group is so highly controversial. In fact, there seems to be no consensus in the orthopaedic society regarding treatment methods. Large systematic reviews of the literature have failed to reveal strong evidence for or against any known treatment in this age group. Pending good-quality evidence, the treatment will remain controversial and surgeon dependent.