Mortality and morbidity following operative management of tibial shaft fractures in octogenarians

Authors

Tom G. Pollard, Department of Orthopedic Surgery, George Washington University Hospital, 2300 M St, Washington, DC, 20037, USA. tomgpollard@gmail.com.
Puneet Gupta, Department of Orthopedic Surgery, George Washington University Hospital, 2300 M St, Washington, DC, 20037, USA.
Theodore Quan, Department of Orthopedic Surgery, George Washington University Hospital, 2300 M St, Washington, DC, 20037, USA.
Pradip Ramamurti, Department of Orthopedic Surgery, George Washington University Hospital, 2300 M St, Washington, DC, 20037, USA.
Joseph E. Manzi, Weill Cornell Medical College, New York, NY, USA.
Safa C. Fassihi, Department of Orthopedic Surgery, George Washington University Hospital, 2300 M St, Washington, DC, 20037, USA.
Alex Gu, Department of Orthopedic Surgery, George Washington University Hospital, 2300 M St, Washington, DC, 20037, USA.
James DeBritz, Department of Orthopedic Surgery, George Washington University Hospital, 2300 M St, Washington, DC, 20037, USA.

Document Type

Journal Article

Publication Date

2-1-2023

Journal

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie

Volume

33

Issue

2

DOI

10.1007/s00590-021-03180-0

Keywords

Complications; Geriatrics; Intramedullary nailing; Open reduction and internal fixation; Tibial shaft fracture

Abstract

PURPOSE: As the geriatric population continues to grow, the incidence of tibial shaft fractures in octogenarians is projected to increase. There is significant variation in the functional and physiologic status within the geriatric population. The purpose of this study is to compare the complications following operative treatment of tibial shaft fractures for patients who are 65- to79-year-old compared to patients who are 80- to 89-year-old. METHODS: Data were collected through the National Surgical Quality Improvement Program database for the years 2007-2018. All isolated tibial shaft fractures that were treated with open reduction internal fixation (ORIF) or intramedullary nail (IMN) were identified. Patients were divided into a 65- to 79-year-old group and an 80-to 89-year-old group. Primary and secondary outcomes were studied and included 30-day mortality. Univariate and multivariate analyses were performed with a significance set at p  <  0.05. RESULTS: In total, 434 patients with tibial shaft fractures were included in the study. Of these, 333 were 65- to 79-year-old and 101 were 80- to 89-year-old (Table 1). On multivariate analysis, there was no significant difference in complication rates between the two cohorts. CONCLUSION: After controlling for demographics and comorbidities, age was not independently associated with 30-day mortality or any other peri-operative complications between patients aged 80 to 89 and patients aged 65 to 79 following operative management of tibial shaft fractures. In appropriately selected octogenarian patients, operative management of tibial shaft fractures represents a relatively safe treatment modality that may promote early rehabilitation.

APA Citation

Pollard, Tom G.; Gupta, Puneet; Quan, Theodore; Ramamurti, Pradip; Manzi, Joseph E.; Fassihi, Safa C.; Gu, Alex; and DeBritz, James, "Mortality and morbidity following operative management of tibial shaft fractures in octogenarians" (2023). GW Authored Works. Paper 2502.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2502

Department

Orthopaedic Surgery