Zusammenfassung
Die prähospitale, stationäre und poststationäre Versorgung von immer mehr hochbetagten
Patienten mit typischen alterstraumatologischen Frakturen stellt eine Herausforderung
für Rettungsdienst, Krankenhäuser und Krankenkassen dar. Diese Herausforderungen in
der Behandlung der alterstraumatologischen „Big Five“ soll im Fokus dieses Artikels
stehen.
Abstract
A continuous increase in geriatric trauma patients can be expected over the next years.
Injuries in geriatric patients are often underestimated and are therefore sometimes
assigned to hospitals that do not have sufficient supply capacities, for example neurosurgery.
Falling is the main cause of trauma in geriatric patients. Slowed reflexes, muscle
wasting and osteoporosis can also lead to severe fractures due to falls from standing
or sitting. Trauma centers specialized for old age can significantly improve the outcome
of geriatric trauma patients. Proximal femoral fractures almost always require surgical
treatment. The aim of the surgical treatment is treatment within 24 hours and rapid
postoperative mobilization under full load. In case of a proximal humerus fracture,
the patientʼs individual requirements, the functional extent before the trauma and
the fracture type must be evaluated in order to determine the appropriate conservative
or surgical treatment. Pelvic ring
fractures cause symptoms similar to those of proximal femoral fractures, but
often cannot be detected in conventional x-rays. If left untreated, they are associated
with persistent pain, immobility, and loss of autonomy. Cervical spine fractures are
often asymptomatic. For this reason, the cervical spine should be immobilized prophylactically
with every head impact. Due to the decrease in brain volume, cerebral hemorrhages
show weakened symptoms with high mortality in geriatric patients.
Schlüsselwörter
Geriatrie - Unfallchirurgie - proximale Femurfrakturen - proximale Humerusfrakturen
- Alterstraumatologie
Key words
geriatrics - trauma surgery - proximal femoral fractures - proximal humerus fractures
- geriatric traumatology
