NS5 - GOLD-FEM: Geriatric Outcomes and Long-term Data on FEMoral fractures
SCURS Disciplines
Medicine & Health Sciences
Document Type
General Presentation (Oral)
Invited Presentation Choice
Not Applicable
Abstract
Introduction: This multicenter study evaluated clinical outcomes and complications following surgical fixation of isolated femoral shaft fractures in patients aged 60 and older.
Methods: Multicenter retrospective review was conducted, including patients 60-90 years of age with surgically managed closed, isolated femoral shaft fractures. Patients were excluded if they had a pathologic femur fracture, preexisting femoral hardware or arthroplasty components, additional injuries requiring surgical intervention, or intra-articular extension. Data collected included demographics, comorbidities, injury characteristics, perioperative details, and postoperative outcomes, including radiographic union, return to baseline function, medical and surgical complications, reoperations, and mortality.
Results: 330 patients, aged 73.8 years (range 60–89.8) met inclusion. The cohort consisted of 73% females. 84% of fractures resulted from low-energy mechanisms. Comorbidities included hypertension (67%), diabetes (32%), coronary artery disease (24%), and osteoporosis (23%). Fractures were stabilized with intramedullary nailing (90%), plate fixation (3%), or combination plate/nail fixation (6%). Mean time from admission to surgery was 1.3 days (range 0–34), to patient-reported full weight-bearing was 6 weeks, and to radiographically visualized union was 5.3 months. 44% of patients were discharged to rehab. We had 2% (7) with superficial and < 1% (3) with deep infection. On average, patients had 1.3 complications each, with 51% of patients experiencing at least one complication. At a median duration of 24 weeks (IQR 11.3–52.0), 17% (42) of patients had not achieved radiographic union. Reoperation occurred in 21 patients (6.4%) including 5 hardware failures and 4 for non-union. In-hospital mortality occurred in 11 patients (3.4%), while 49 additional patients (14.8%) experienced mortality following discharge, resulting in an overall observed mortality of 18% (60 patients).
Discussion/Conclusions: Geriatric femoral shaft fractures were associated with high rates of medical complications, non-home discharge, nonunion and additional surgery. These findings should encourage perioperative management protocols and counseling in this vulnerable population.
Keywords
femoral fracture, clinical outcomes, geriatric, orthopedics, femoral fixation
Start Date
10-4-2026 3:25 PM
Location
CASB 105
End Date
10-4-2026 3:40 PM
NS5 - GOLD-FEM: Geriatric Outcomes and Long-term Data on FEMoral fractures
CASB 105
Introduction: This multicenter study evaluated clinical outcomes and complications following surgical fixation of isolated femoral shaft fractures in patients aged 60 and older.
Methods: Multicenter retrospective review was conducted, including patients 60-90 years of age with surgically managed closed, isolated femoral shaft fractures. Patients were excluded if they had a pathologic femur fracture, preexisting femoral hardware or arthroplasty components, additional injuries requiring surgical intervention, or intra-articular extension. Data collected included demographics, comorbidities, injury characteristics, perioperative details, and postoperative outcomes, including radiographic union, return to baseline function, medical and surgical complications, reoperations, and mortality.
Results: 330 patients, aged 73.8 years (range 60–89.8) met inclusion. The cohort consisted of 73% females. 84% of fractures resulted from low-energy mechanisms. Comorbidities included hypertension (67%), diabetes (32%), coronary artery disease (24%), and osteoporosis (23%). Fractures were stabilized with intramedullary nailing (90%), plate fixation (3%), or combination plate/nail fixation (6%). Mean time from admission to surgery was 1.3 days (range 0–34), to patient-reported full weight-bearing was 6 weeks, and to radiographically visualized union was 5.3 months. 44% of patients were discharged to rehab. We had 2% (7) with superficial and < 1% (3) with deep infection. On average, patients had 1.3 complications each, with 51% of patients experiencing at least one complication. At a median duration of 24 weeks (IQR 11.3–52.0), 17% (42) of patients had not achieved radiographic union. Reoperation occurred in 21 patients (6.4%) including 5 hardware failures and 4 for non-union. In-hospital mortality occurred in 11 patients (3.4%), while 49 additional patients (14.8%) experienced mortality following discharge, resulting in an overall observed mortality of 18% (60 patients).
Discussion/Conclusions: Geriatric femoral shaft fractures were associated with high rates of medical complications, non-home discharge, nonunion and additional surgery. These findings should encourage perioperative management protocols and counseling in this vulnerable population.