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

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

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.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, George Washington University Hospital, 2300 M St, Washington, DC, 20037, USA

    Tom G. Pollard, Puneet Gupta, Theodore Quan, Pradip Ramamurti, Safa C. Fassihi, Alex Gu & James DeBritz

  2. Weill Cornell Medical College, New York, NY, USA

    Joseph E. Manzi

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  1. Tom G. Pollard
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Correspondence to Tom G. Pollard.

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Pollard, T.G., Gupta, P., Quan, T. et al. Mortality and morbidity following operative management of tibial shaft fractures in octogenarians. Eur J Orthop Surg Traumatol 33, 299–304 (2023). https://doi.org/10.1007/s00590-021-03180-0

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  • DOI: https://doi.org/10.1007/s00590-021-03180-0

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