Book contents
- Frontmatter
- Contents
- Editorial Advisory Committee
- Contributors
- Acknowledgments
- 1 Essential Principles in the Care of the Elderly
- 2 Assessment of the Older Patient
- 3 Prevention for Older Adults
- 4 Common Complaints in the Elderly
- 5 Appropriate Use of Medications in the Elderly
- 6 Nutrition and Aging
- 7 Using Exercise as Medicine for Older Adults
- 8 Diabetes Mellitus in the Older Adult
- 9 Lipid Management in Older Patients
- 10 Hypertension
- 11 Diagnosis and Management of Heart Disease in the Elderly
- 12 Peripheral Arterial Disease in the Elderly
- 13 Stroke in the Older Adult
- 14 Neurological Problems in the Elderly
- 15 Recognition and Management of Delirium
- 16 Evaluation and Management of Dementia
- 17 Clinical Geropsychiatry
- 18 Alcohol and Other Drug Abuse in Older Patients
- 19 Aging in Adults with Developmental Disabilities
- 20 Pulmonary Issues in the Elderly
- 21 Gastroenterological Disease in the Older Adult
- 22 Serious Infections in the Elderly
- 23 Human Immunodeficiency Virus in the Elderly
- 24 Principles of Fluid and Electrolyte Balance and Renal Disorders in the Older Patient
- 25 Urological Issues in Older Adults
- 26 Urinary Incontinence
- 27 Geriatric Gynecology
- 28 Disorders of the Endocrine Glands
- 29 Osteoporosis and Other Metabolic Disorders of the Skeleton in Aging
- 30 Common Rheumatic Diseases in the Elderly
- 31 Musculoskeletal Injuries in the Elderly
- 32 Foot Health for the Elderly: Podogeriatric Overview
- 33 Geriatric Dermatology
- 34 Pressure Ulcers: Practical Considerations in Prevention and Treatment
- 35 Anemia and Other Hematological Problems of the Elderly
- 36 Cancer in the Elderly
- 37 Eye Problems of the Aged
- 38 Geriatric Ear, Nose, and Throat Problems
- 39 Geriatric Dentistry
- 40 Surgical Principles in the Aged
- 41 Rehabilitation in Older Adults
- 42 Community-Based Long-Term Care
- 43 Institutional Long-Term Care
- 44 Care for the Elderly Patient at the End of Life
- 45 Assessment of Decision-Making Capacity
- 46 Injuries in Older Adults
- 47 The Mistreatment of Older Adults
- 48 Driving and the Older Adult
- 49 Integrative Medicine in the Care of the Elderly
- 50 Successful Aging: Optimizing Strategies for Primary Care Geriatrics
- 51 Cell Biology and Physiology of Aging
- 52 Implications of an Aging Society
- 53 Ethnogeriatrics
- 54 Retirement
- 55 Geriatric Sexuality
- 56 The Elderly, Their Families, and Their Caregivers
- 57 Systematic Approaches to Preventing Errors in the Care of the Elderly
- 58 Health Care Organization and Financing
- 59 Advance Care Planning: Values and Families in End-of-Life Care
- 60 Ethical Decision Making in Geriatric Medicine
- Index
- Plate section
31 - Musculoskeletal Injuries in the Elderly
Published online by Cambridge University Press: 19 May 2010
- Frontmatter
- Contents
- Editorial Advisory Committee
- Contributors
- Acknowledgments
- 1 Essential Principles in the Care of the Elderly
- 2 Assessment of the Older Patient
- 3 Prevention for Older Adults
- 4 Common Complaints in the Elderly
- 5 Appropriate Use of Medications in the Elderly
- 6 Nutrition and Aging
- 7 Using Exercise as Medicine for Older Adults
- 8 Diabetes Mellitus in the Older Adult
- 9 Lipid Management in Older Patients
- 10 Hypertension
- 11 Diagnosis and Management of Heart Disease in the Elderly
- 12 Peripheral Arterial Disease in the Elderly
- 13 Stroke in the Older Adult
- 14 Neurological Problems in the Elderly
- 15 Recognition and Management of Delirium
- 16 Evaluation and Management of Dementia
- 17 Clinical Geropsychiatry
- 18 Alcohol and Other Drug Abuse in Older Patients
- 19 Aging in Adults with Developmental Disabilities
- 20 Pulmonary Issues in the Elderly
- 21 Gastroenterological Disease in the Older Adult
- 22 Serious Infections in the Elderly
- 23 Human Immunodeficiency Virus in the Elderly
- 24 Principles of Fluid and Electrolyte Balance and Renal Disorders in the Older Patient
- 25 Urological Issues in Older Adults
- 26 Urinary Incontinence
- 27 Geriatric Gynecology
- 28 Disorders of the Endocrine Glands
- 29 Osteoporosis and Other Metabolic Disorders of the Skeleton in Aging
- 30 Common Rheumatic Diseases in the Elderly
- 31 Musculoskeletal Injuries in the Elderly
- 32 Foot Health for the Elderly: Podogeriatric Overview
- 33 Geriatric Dermatology
- 34 Pressure Ulcers: Practical Considerations in Prevention and Treatment
- 35 Anemia and Other Hematological Problems of the Elderly
- 36 Cancer in the Elderly
- 37 Eye Problems of the Aged
- 38 Geriatric Ear, Nose, and Throat Problems
- 39 Geriatric Dentistry
- 40 Surgical Principles in the Aged
- 41 Rehabilitation in Older Adults
- 42 Community-Based Long-Term Care
- 43 Institutional Long-Term Care
- 44 Care for the Elderly Patient at the End of Life
- 45 Assessment of Decision-Making Capacity
- 46 Injuries in Older Adults
- 47 The Mistreatment of Older Adults
- 48 Driving and the Older Adult
- 49 Integrative Medicine in the Care of the Elderly
- 50 Successful Aging: Optimizing Strategies for Primary Care Geriatrics
- 51 Cell Biology and Physiology of Aging
- 52 Implications of an Aging Society
- 53 Ethnogeriatrics
- 54 Retirement
- 55 Geriatric Sexuality
- 56 The Elderly, Their Families, and Their Caregivers
- 57 Systematic Approaches to Preventing Errors in the Care of the Elderly
- 58 Health Care Organization and Financing
- 59 Advance Care Planning: Values and Families in End-of-Life Care
- 60 Ethical Decision Making in Geriatric Medicine
- Index
- Plate section
Summary
Orthopedic trauma in the elderly patient presents both a medical and a surgical challenge. This growing population requires injury management tailored to specific patient needs. Injury treatment is based on patient factors, injury factors, and other special considerations to optimize outcome. The goal of injury treatment in the elderly patient is enabling return to preinjury functional status. This chapter will focus on the treatment of some of the more common injuries encountered in the elderly, including proximal humerus fractures, rotator cuff tears, wrist fractures, hip fractures, ankle fractures, and vertebral compression fractures.
PATIENT FACTORS
Preinjury Status
The goal of injury treatment in the elderly patient is a return to preinjury status. Therefore, a thorough history-taking that includes preinjury function is pivotal to guiding effective orthopedic care. The treatment goals of an independent community-dwelling ambulatory patient who sustains a hip fracture are different from those of an institutionalized nonambulatory patient. The former requires early operative intervention combined with aggressive postoperative rehabilitation, whereas the latter requires a less aggressive approach that provides for comfortable transfers and the ability to sit. Although the goal of each is to return to preinjury status, the approaches to each differ significantly.
Systemic Disease
Elderly patients often have preexisting medical comorbidities that influence musculoskeletal injury treatment. Cardiopulmonary disease is common in this population and affects the patient's ability to tolerate anesthetics, undergo surgery, and participate in a postoperative rehabilitation program.
- Type
- Chapter
- Information
- Reichel's Care of the ElderlyClinical Aspects of Aging, pp. 324 - 335Publisher: Cambridge University PressPrint publication year: 2009