An Additional Certification as a Centre for Geriatric Trauma Had No Benefit on Mortality Among Seriously Injured Elderly Patients-An Analysis of the TraumaRegister DGU with Data of the Registry for Geriatric Trauma (ATR-DGU).

: The number of seriously injured elderly patients is continuously rising. Several studies have underlined the benefit of orthogeriatric co-management in treating older patients with a proximal femur fracture. The basis of this orthogeriatric co-management is a certification as a Centre for Geriatric Trauma (ATZ).

Outcome of Centenarians with Hip Fracture: An Analysis of the Registry for Geriatric Trauma (ATR-DGU).

Outcomes for hip fracture patients have improved over the years, yet the population of older patients (≥80 years) continues to grow. By 2100, the global centenarian population is projected to exceed 25 million, but data on hip fracture outcomes in this group are rare and often derived from small samples. This study aimed to analyze outcomes for centenarian hip fracture patients in specialized geriatric trauma centers and compare them with those of patients under 80.

Validation of the Geriatrics at Risk Score (GeRi-Score) on 120-day follow-up, the influence of preoperative geriatric visits, and the time to surgery on the outcome of hip fracture patients: an analysis from the Registry for Geriatric Trauma (ATR-DGU).

Unlabelled: A validation of the GeRi-Score on 120-day mortality, the impact of a pre-operative visit by a geriatrician, and timing of surgery on the outcome was conducted. The score has predictive value for 120-day mortality. No advantage was found for surgery within 24 h or a preoperative geriatric visit.

[Conservative fracture treatment in old people].

The numbers of osteoporotic fractures will increase due to the demographic change, which particularly affects the proximal femur, pelvis, proximal humerus, wrist and vertebral column. Surgical treatment is superior to conservative treatment of proximal femoral fractures. Non-dislocated fractures of the wrist can also be treated with a plaster cast but studies suggest that the results in the first 12 months are better after surgical treatment.

Surgical management and outcomes following atypical subtrochanteric femoral fractures - results from a matched-pair analysis of the registry for geriatric trauma of the German Trauma Society.

Background And Objectives: The outcomes of patients with atypical subtrochanteric fractures (ASFs) remain unclear. Data from a large international geriatric trauma registry were analysed to examine the outcome of patients with ASFs compared to patients with typical osteoporotic subtrochanteric fractures (TSFs).

Materials And Methods: Data from the Registry for Geriatric Trauma of the German Trauma Society (Deutsche Gesellschaft für Unfallchirurgie [DGU]) (ATR-DGU) were analysed.

Reality of treatment for severely injured patients: are there age-specific differences?

Background: Major trauma and its consequences are one of the leading causes of death worldwide across all age groups. Few studies have conducted comparative age-specific investigations. It is well known that children respond differently to major trauma than elderly patients due to physiological differences.

[Effects of the COVID-19 pandemic on the course of geriatric trauma patients with proximal femoral fractures].

Background/objective: In 2020 the COVID-19 pandemic posed a major challenge to the healthcare system. The hypothesis is that the COVID-19 pandemic in 2020 had an impact on the care of older adults with proximal femoral fractures due to resource scarcity, regardless of whether or not the patient was infected.

Material And Methods: This study analyzed the data of 87 hospitals which entered 15,289 patients in the Geriatric Trauma Register ("AltersTraumaRegister DGU®", ATR-DGU) in Germany in 2019 and 2020.

Liberal intraoperative fluid management leads to increased complication rates in geriatric patients with hip fracture.

Purpose: Fractures of the proximal femur in geriatric patients are life-changing and life-threatening events. Previous research has identified fluid volume as an independent factor contributing to trauma patients' complications. Therefore, we aimed to investigate the impact of intraoperative fluid volume on outcomes in geriatric patients undergoing hip fracture surgery.

Spinal anesthesia with better outcome in geriatric hip fracture surgery - An analysis of the Registry for Geriatric Trauma (ATR-DGU).

Background: Literature shows conflicting results regarding spinal (SA) or general anesthesia (GA) and their influence on the outcome of elderly patients with hip fractures. We, therefore, conducted an analysis from the Registry for Geriatric Trauma (ATR-DGU).

Methods: A retrospective, multicenter registry study including patients aged 70 years or above with hip fractures requiring surgery from 131 Centers for Geriatric Trauma (AltersTraumaZentrum DGU®) from 2016 to 2021.

Time to surgery after proximal femur fracture in geriatric patients depends on hospital size and provided level of care: analysis of the Registry for Geriatric Trauma (ATR-DGU).

Purpose: Proximal femur fractures predominantly affect older patients and can mark a drastic turning point in their lives. To avoid complications and reduce mortality, expert associations recommend surgical treatment within 24-48 h after admission. Due to the high incidence, treatment is provided at a wide range of hospitals with different size and level of care, which may affect time to surgery.

The Geriatrics at Risk Score (GeRi-Score) for mortality prediction in geriatric patients with proximal femur fracture - a development and validation study from the Registry for Geriatric Trauma (ATR-DGU).

Unlabelled: This study developed an easy-to-use mortality prediction tool, which showed an acceptable discrimination and no significant lack of fit. The GeRi-Score was able to predict mortality and could distinguish between mild, moderate and high risk groups. Therefore, the GeRi-Score might have the potential to distribute the intensity of medical care.

Biomechanical analysis of helical versus straight plating of proximal third humeral shaft fractures.

Background: Proximal humeral shaft fractures are surgically challenging and plate osteosynthesis with a long straight plate is one operative treatment option in these patients although endangering the radial nerve distally. Helical plates potentially avoid the radial nerve by twisting around the humeral shaft. Aim of the study was to investigate in a human cadaveric model the biomechanical competence of helical plates versus straight lateral plates used for fixation of proximal third comminuted humeral shaft fractures.

Current Management of Hip Fracture.

This Special Issue, entitled "Current Management of Hip Fracture", ran in the journal of MDPI's "Surgery" section, reports the findings of international studies regarding different aspects in the treatment of patients suffering a proximal femur fracture [...

Does stem profile have an impact on the failure patterns in revision total knee arthroplasty?

Introduction: Revision total knee arthroplasty (RTKA) has been increasing continuously. The results of RTKA still remain unsatisfactory. Failure patterns and risk factors in RTKA were thoroughly analyzed, with periprosthetic joint infections (PJI) and aseptic loosening remaining at the forefront of re-revision (ReRTKA) causes.

The Influence of Malnutrition Measured by Hypalbuminemia and Body Mass Index on the Outcome of Geriatric Patients with a Fracture of the Proximal Femur.

Fractures of the proximal femur are a life-changing and life-threatening event for older people. Concomitant malnutrition has been described as an independent risk factor for complications and mortality. Therefore, we examined the influence of albumin and body mass index (BMI) as parameters for the nutritional state on the outcome after geriatric hip fracture surgery.

Anatomical analysis of different helical plate designs for proximal humeral shaft fracture fixation.

Objectives: Helical plates are preferably used for proximal humeral shaft fracture fixation and potentially avoid radial nerve irritation.

Aims: Safety of applying four different long plate designs (straight, 45°-, 90°-helical and ALPS) with MIPO technique as well as assessment and comparison of their distances to adjacent anatomical structures.

Methods: MIPO was performed in 16 human cadaveric humeri using either a straight (group 1), a 45°-helical (group 2), a 90°-helical (group 3) plate, or an ALPS (group 4).

Impact of stem profile on the revisability and the need for osteotomy in well-fixed cemented revision total knee arthroplasty implants.

Introduction: While re-revision total knee arthroplasty (ReRTKA) steadily increases, the ease and bone-sparing removal of RTKA implants is gaining more and more in importance. Biomechanical data suggest that cemented conical stems can be removed significantly easier than cylindrical stems. However, no clinical evidence exists supporting this observation.

Surgical Management and Outcomes following Pathologic Hip Fracture-Results from a Propensity Matching Analysis of the Registry for Geriatric Trauma of the German Trauma Society.

The outcomes of patients with pathologic hip fractures remain unclear. Data from a large international geriatric trauma registry were analyzed to examine the outcomes of patients with pathologic hip fractures compared with patients with typical osteoporotic hip fractures. Data from the Registry for Geriatric Trauma of the German Trauma Society (Deutsche Gesellschaft für Unfallchirurgie (DGU)) (ATR-DGU) were analyzed.

Effect of Direct Oral Anticoagulants on Treatment of Geriatric Hip Fracture Patients: An Analysis of 15,099 Patients of the AltersTraumaRegister DGU.

The increased use of direct oral anticoagulants (DOACs) results in an increased prevalence of DOAC treatment in hip fractures patients. However, the impact of DOAC treatment on perioperative management of hip fracture patients is limited. In this study, we describe the prevalence of DOAC treatment in a population of hip fracture patients and compare these patients with patients taking vitamin K antagonists (VKA) and patients not taking anticoagulants.

RIA versus iliac crest bone graft harvesting: A meta-analysis and systematic review.

Background: Reamer-Irrigator-Aspirator (RIA) of long bones is increasingly being used as an alternative to iliac crest harvesting for bone-grafts. This meta-analysis compares both harvesting techniques with regard to donor site morbidity, healing potency and implantation site morbidity.

Methods: PubMed/Medline/Embase/CENTRAL/CINAHL were searched for both randomized clinical trials (RCT) and observational studies.

COVID-19 and Proximal Femur Fracture in Older Adults-A Lethal Combination? An Analysis of the Registry for Geriatric Trauma (ATR-DGU).

Objectives: COVID-19 can be a life-threatening illness, especially for older patients. The COVID-19 outbreak created a dramatic organizational challenge in treating infected patients requiring surgical treatment, like those suffering a proximal femur fracture, in a pandemic setting. We investigate the impact of a COVID-19 infection in patients with a proximal femur fracture not only on mortality but also on quality of life (QoL), length of stay, and discharge target.

Trochanteric Femur Fractures: Application of Skeletal Traction during Surgery Does Not Alter Soft-Tissue Microcirculation.

: Wound infections provoked by alterations in microcirculation are major complications in the treatment of trochanteric femur fractures. Surgical fracture fixation on a traction table is the gold standard for treatment, but the effect on tissue microcirculation is unknown. Microcirculation could be impaired by the pull on the soft-tissue or by a release of vasoactive factors.

Impact of concomitant injuries in geriatric patients with proximal femur fracture : an analysis of the Registry for Geriatric Trauma.

Aims: The impact of concomitant injuries in patients with proximal femoral fractures has rarely been studied. To date, the few studies published have been mostly single-centre research focusing on the influence of upper limb fractures. A retrospective cohort analysis was, therefore, conducted to identify the impact and distribution of concomitant injuries in patients with proximal femoral fractures.

Which factors influence treatment decision in fragility fractures of the pelvis? - results of a prospective study.

Background: The aim of the present study was to describe specific characteristics of patients suffering from pelvic fragility fractures and evaluate factors that might influence treatment decisions which may optimize treatment pathways and patient mobility in the future.

Methods: A prospective study with patients suffering from fractures of the pelvis and aged 60 years or above was performed between 2012 and 2016. Data acquisition took place at admission, every day during hospitalization and at discharge.

Open Reduction in Subtrochanteric Femur Fractures Is Not Accompanied by a Higher Rate of Complications.

: Hip fractures are among the most typical geriatric fractures. Subtrochanteric fractures are considered difficult to treat, and, to date, there is no consensus on the optimal surgical treatment. : We analyzed data from the Registry for Geriatric Trauma, which includes patients ≥ 70 years old with hip fractures or periprosthetic fractures requiring surgery (21,734 patients in 2017-2019).