Author:
van Trikt Clinton H.,Donders Johanna C. E.,Klinger Craig E.,Wellman David S.,Helfet David L.,Kloen Peter
Abstract
Abstract
Background
Limited information exists on nonunion treatment in the elderly. This retrospective study evaluates whether results of operative treatment of nonunion of the humerus or femur in patients aged ≥ 75 years are comparable to those in younger patients.
Methods
We identified patients age ≥ 75 years with a nonunion of humerus or femur treated with open reduction and internal fixation. The Non-Union Scoring System was calculated. Complications, clinical outcome, and radiographic findings were assessed. Primary endpoint was nonunion healing. A literature review compared time to healing of humeral and femoral nonunion in younger populations.
Results
We identified 45 patients treated for a nonunion of humerus or femur with > 12 months follow-up. Median age was 79 years (range 75–96). Median time to presentation was 12 months (range 4–127) after injury, median number of prior surgeries was 1 (range 0–4). Union rate was 100%, with median time to union 6 months (range 2–42). Six patients underwent revision for persistent nonunion and healed without further complications.
Conclusions
Using a protocol of debridement, alignment, compression, stable fixation, bone grafting and early motion, patients aged 75 years or older can reliably achieve healing when faced with a nonunion of the humerus or femur.
Level of Evidence: IV.
Funder
Marti-Keunig-Eckhardt Foundation
Herman Heinsbroek Foundation
Publisher
Springer Science and Business Media LLC
Subject
Geriatrics and Gerontology
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