Future of orthogeriatrics from the perspective of a geriatrician

Abstract

In the elderly, fractures and other severe injuries frequently lead to substantial restrictions in the activities of daily living (ADLs) resulting in dependency. Typical complications following a fracture include acute delirium, deep vein thrombosis, pneumonia and other infections. It has been demonstrated that early surgery (osteosynthesis) and early mobilization significantly decrease the risk of these complications. An interdisciplinary cooperation between orthopedic surgeons and geriatricians leads to a shorter length of hospitalization, better mobility and, most importantly, to an improvement in the quality of life. Furthermore, treatment on an interdisciplinary orthogeriatric traumatology ward can prevent patients becoming reliant on long-term care and therefore decreases the risk of being admitted to a nursing home. The role of the geriatrician in the treatment of orthogeriatric patients includes treatment of internal medical comorbidities, geriatric assessments, coordination of the geriatric team as well as diagnostics and treatment of osteoporosis. In the future, the geriatrician's task will include the preoperative evaluation of orthogeriatric patients, which is already a routine procedure in many orthogeriatric centers. The aim of this article is to summarize the evidence from the currently available literature for interdisciplinary treatment of orthogeriatric patients and to give an overview of the diagnostic and therapeutic interventions relevant to the routine practice for the orthopedic surgeon.