Search Results (107)

Frailty is a multidomain reduction in physiologic reserve that impacts recovery and can contribute to poor outcomes following trauma beyond what chronological age, comorbidities, or injury severity predicts. In geriatric trauma patients, a large proportion are frail or prefrail on initial encounter in the emergency department, and because there are opportunities for actionable management plans, major trauma guidelines endorse systematic screening integrated into coordinated geriatric trauma care. We reviewed the literature and identified practical instruments used in the acute trauma setting for risk stratification. Additionally, we highlight the feasibility of using these instruments, as some can be completed via patient report, proxy input, or chart review when cognition, language, or caregiver availability limits history-taking. Implementation efforts succeed when shared mental models are leveraged and screening is embedded in the electronic health record system, linked to order sets and trigger-based pathways that offer downstream goal-directed care management, such as early mobility, delirium prevention, nutrition, medication review, and comprehensive geriatric assessment. Additionally, we highlight the importance of initiating early goals-of-care discussions and coordinating care with palliative care services. Resource-limited systems can preserve the same architecture by using nurse-led or allied staff-led screening, tele-geriatric consultation, and virtual interdisciplinary huddles. Lastly, we expand upon opportunities for longitudinal post-discharge follow-up. We describe how targeted initiatives translate research into practice, improve outcomes, and support longitudinal reassessment through in-person and telehealth follow-up visits. Full article

Background/objective: Maxillofacial fractures continue to represent a significant public health issue, with incidence patterns shaped by regional and demographic variables. This study aimed to deliver a comprehensive 15-year epidemiological analysis of maxillofacial trauma cases in southern Hungary. Methods: The study included patients who received treatment for maxillofacial trauma at the University of Pécs from 2009 to 2023. Data collected encompassed demographic characteristics, injury etiology, fracture location and complexity, date of injury, presence of alcohol involvement, therapeutic interventions, postoperative complications and reasons, and number of fixation plates removed. Descriptive statistics and odds ratios were calculated, with statistical significance defined as p < 0.05. Results: Among 1948 patients (69.9% male), a total of 2826 fractures were reported, averaging 1.45 fractures per patient. The most frequently affected age group was 21–30 years; however, a notable increase in cases among the elderly was observed for recent years. Falls accounted for the highest proportion of injuries (44.4%), followed by assaults (28.3%) and traffic accidents (16.8%). Injuries predominantly occurred on weekends, with Saturdays being particularly common. Alcohol consumption was documented in 14.7% of cases. The condyle (27.9%), body (25.7%), and angle (25.0%) were the most common sites of mandibular fracture. The maxillary sinus and zygomatic body were the leading sites of maxillofacial fractures. Conservative treatment was implemented in 54.6% of all cases, whereas surgical intervention was more frequently required for mandibular injuries (76.7%). Plate removal was performed in 15.3% of patients. Conclusions: During the study period, the incidence of maxillofacial trauma demonstrated a consistent increase, accompanied by demographic changes indicative of an aging population and a reduction in assault-related cases. Falls—especially among older adults—became the leading cause of injury. These results emphasize the necessity for targeted prevention efforts, geriatric-specific trauma management, and the implementation of health policies tailored to regional needs. Full article

Background/Objectives: While direct oral anticoagulants (DOACs) are widely used, robust evidence for low-energy trauma is scarce. Studies have shown similar or better outcomes of traumatic brain injury (TBI) under DOAC therapy compared to vitamin K antagonists, but there is limited data on the differences among DOAC types. Methods: We performed a retrospective study of TBI patients with pre-injury DOACs who presented to our level 1 trauma unit and received cranial computed tomography. Only low-energy trauma mechanisms were included. Results: We included 643 patients with an average age of 82 years. As per the Glasgow Coma Scale, 637 patients (99.1%) had a mild TBI and 34 patients (5.3%) had intracranial hematomas. No delayed intracranial bleeding occurred during in-hospital observation. Rivaroxaban was the most frequent DOAC (278, 43.2%), followed by apixaban (221, 34.4%), dabigatran (84, 13.1%), and edoxaban (60, 9.3%). Neurosurgical interventions were performed in three cases (0.5%). The head injury-related in-hospital mortality was 0.9% (six patients). Fisher’s Exact Test and regression analysis did not demonstrate statistically significant differences among the DOAC types regarding occurrence of intracranial bleeding, surgical interventions, or mortality. Conclusions: We found no statistically significant differences between DOACs regarding complications of TBI after low-energy trauma. This study shows an overall low risk of complications after low-energy trauma in a predominantly geriatric population with TBI and DOAC therapy. Full article

Background/Objectives: Hip fracture is a condition with increasing hospital demand, and the determinants of hospital stay are crucial for improving clinical outcomes and costs in this vulnerable population. To establish the determinants of the length of hospital stay (HS) of older adult patients with hip fractures in a hospital in the Lambayeque region of Peru during 2017–2019. Methods: We conducted an observational study based on a secondary data analysis. The outcome variable was HS, measured in terms of days from admission to the hospitalization unit until discharge. The main independent variables were age, functional ambulation category scale, cognitive status index (Mental Red Cross scale), Barthel index, comorbidities, geriatric syndromes, trauma diagnosis, reason for surgical delay, preoperative time and preoperative complications. We performed a Poisson or negative binomial regression through crude and adjusted models. Results: Of 399 patients, the average age was 82.25 years, with 63.7% being female. A Poisson and negative binomial regression analysis were conducted for the variables that were significant in the crude model, which were sex, multimorbidity, mental Red Cross scale, Barthel index, functional ambulation, number of geriatric syndromes, traumatic diagnosis, reason for delay in the first model, preoperative complications in the first model, emergency stay, and preoperative time in the second model. According to the adjusted model, the analysis found that in the first model, advanced dementia as measured by the Mental Red Cross (MRC) scale was associated with an increase in hospital length of stay (IRR = 1.82, 95% CI = 1.03–3.23, p < 0.04); similarly, having preoperative complications increased hospital length of stay (IRR = 1.56, 95% CI = 1.30–1.86, p < 0.001), adjusted for clinical variables; in the second model, preoperative time was associated with an increase in hospital length of stay (IRR = 7.44, 95% CI = 6.96–7.96, p < 0.001), adjusted for emergency department stay. A third global model was developed, finding that advanced dementia as measured by the MRC (IRR = 1.82, 95% CI = 1.02–3.23, p < 0.04) and the presence of preoperative complications (IRR = 1.56, 95% CI = 1.30–1.86, p < 0.04) were associated with increased hospital length of stay, adjusted for clinical and hospital variables. Conclusions: The average HS of older adult hip fracture patients treated at a tertiary hospital in the Lambayeque region of Peru was 17 days. The main determinants of HS duration were advanced dementia and presence of preoperative complications. Full article

Aim: Older adult pedestrians are at greater risk of severe injuries than younger pedestrians due to gradual physical changes and coexisting medical conditions. This leads to longer hospital stays, increased mortality risk, and higher inpatient costs. Focusing on the aging population, this study explores the characteristics and injury profiles of pedestrian crossing accidents in the capital city of Bern, Switzerland. Methods: Our retrospective cohort study comprised adult patients admitted to our ED between 1 January 2013 and 31 December 2023, as crossing (or zebra crossing)-related pedestrian victims. Two cohorts were formed on the basis of age < 65 and ≥65 years and compared according to the setting of the accident, type, pattern of the injury, and clinical outcomes (short-term mortality, ICU/hospital length of stay). Results: Of a total of 124 patients, 31.5% (n = 39) of patients were elderly (65+ group). In contrast to the younger patients, the aging population was predominantly admitted as inpatients (64.1% vs. 35.3%, p = 0.001) and was hospitalised in the intensive care unit (20.5% vs. 6%, p = 0.020). Older patients were more likely to be polytraumatised (41% vs. 11.8%, p = 0.001) and to have been tossed or hurled than patients under 65 years (75% vs. 47.3%, p = 0.016). Fractures of the upper extremities (17.9% vs. 4.7%, p = 0.016), pelvis (30.8% vs. 9.4%, p = 0.003), and thoracic spine (12.8% vs. 2.4%, p = 0.019) were significantly more common in the elderly population. Intracranial haemorrhage (35.9% vs. 17.6%, p = 0.026), abdominal trauma (17.9% vs. 5.9%, p = 0.035), and relevant vessel damage (30.8% vs. 3.5%, p < 0.001) were also significantly higher in geriatric patients. Trauma indices were slightly more increased in the older population than in the younger group (ISS; p = 0.004 and AIS > 2 of chest and thoracic spine; abdomen, pelvic contents, and lumbar spine; extremities & bony pelvis p < 0.05). The 65+ group had a longer length of hospital stay (p = 0.001) and ICU stay (p = 0.002). A hospital stay longer than 7 days was also significantly more common in elderly individuals (p = 0.007). In-hospital (15.4% vs. 1.2%, p = 0.001) and 30-day mortality (17.9% vs. 1.2%, p < 0.001) were significantly higher in patients over 65 years of age. Conclusion: In our study, the impact of pedestrian crossing accidents was more severe in the elderly, as indicated by the severity of injuries, hospitalisation rate, longer length of hospital and ICU stays, and higher mortality rates. These findings underline the importance of developing tailored strategies to reduce crosswalk accidents and to optimise management approaches for these vulnerable patients. Full article

Objectives: This prospective observational study aimed to assess the prognostic value of electrocardiographic (ECG) findings obtained at emergency department (ED) admission in adult patients presenting with trauma-related fractures, with a focus on their association with 30-day all-cause mortality. Materials and Methods: A total of 391 patients aged ≥18 years with trauma-induced fractures were enrolled at a tertiary emergency center between February and May 2025. Baseline demographic and clinical data, including comorbidities, trauma mechanisms, and 12-lead ECG findings at admission, were recorded. Patients were monitored for 30-day mortality. Logistic regression analysis was used to identify independent predictors of mortality. Results: The mean age of the patients was 73.9 ± 6.7 years, and 50.1% were female. Normal sinus rhythm was the most common ECG finding (31.5%), followed by sinus tachycardia (20.5%) and bundle branch block (15.3%), while atrial fibrillation (AF) was present in 9.5% of cases. Thirty-day mortality occurred in 5.1% of the cohort (n = 20). Non-survivors had significantly higher frequencies of AF (35.0% vs. 8.1%, p = 0.001), head trauma (70.0% vs. 18.1%, p < 0.001), cerebrovascular disease (55.0% vs. 16.4%, p < 0.001), and polypharmacy (100% vs. 62.8%, p = 0.001) compared with survivors. Conversely, low-energy falls were more common among survivors (74.7% vs. 20.0%, p < 0.001), whereas falls from stairs or a bed and high-energy trauma were significantly more frequent among non-survivors (all p < 0.05). In multivariate logistic regression, AF (OR: 6.112; 95% CI: 1.612–23.176; p = 0.008), head trauma (OR: 16.514; 95% CI: 4.925–55.367; p < 0.001), and cerebrovascular disease (OR: 6.725; 95% CI: 2.219–20.385; p = 0.001) emerged as independent predictors of 30-day mortality. Although normal sinus rhythm was associated with survival in univariate analysis (p = 0.034), it did not retain independent significance in multivariate modeling. Patients with AF had significantly lower 30-day survival compared with those without AF (65.0% vs. 96.3%, p = 0.001). Conclusions: This prospective study demonstrates that electrocardiographic abnormalities—especially atrial fibrillation—are strong predictors of 30-day mortality in older adult trauma patients. Their prognostic value was further reinforced when assessed alongside head trauma and cerebrovascular disease. These findings emphasize ECG as a rapid, practical, and noninvasive tool for early risk stratification and clinical decision-making in the emergency care of geriatric fracture patients. Full article

Background/Objectives: Periprosthetic acetabular fractures in older adults are rare compared to other fractures of the hip. Nevertheless, their incidence is increasing due to an aging population with a growing number of total hip arthroplasties. Surgical management is complex, often involving frail patients, and one might expect an elevated risk of postoperative mortality. This study aimed to (1) determine the one-year mortality rate after operative treatment and (2) assess the perioperative complication rate of periprosthetic compared to native acetabular fractures. Methods: We identified 136 surgically treated acetabular fractures in patients ≥ 60 years (2012–2019): 31 periprosthetic and 105 native fractures. We performed case–control matching based on gender, frailty, osteoporosis, and comorbidities, yielding two matched cohorts (31 per group). (1) All patients were contacted, and the one-year mortality was assessed with Kaplan–Meier survivorship analysis before and after matching. (2) The perioperative complication rate was graded according to Sink. Results: (1) One-year mortality was 10% in the periprosthetic group vs. 20% in the native group (p = 0.19). After matching, no significant difference in the mortality rate was observed (10% vs. 23%, p = 0.17). (2) Overall complication rates were 61% in the periprosthetic group and 70% in the native group (p = 0.39). Conclusions: We observed a one-year mortality rate for periprosthetic acetabular fractures that was comparable to that of native acetabular fractures. Full article

Background/Objectives: Femoral neck and proximal femur fractures in the elderly can result from low-energy trauma due to osteoporotic changes and contribute significantly to increased morbidity and mortality. Despite various treatment options, closed reduction and internal fixation (CRIF) with intramedullary nails has become the predominant approach. While a minimally invasive approach reduces complications and speeds recovery, this outcome is not always feasible in practice. The primary surgical goal remains achieving a stable and precise fracture reduction, favoring CRIF when possible. Our study aims to evaluate the clinical, radiological, and functional outcomes of patients operated on using the Wide-Awake Local Anesthesia No Tourniquet (WALANT) technique. Methods: Patients who underwent surgery for intertrochanteric femur fractures between June 2019 and June 2021 were analyzed. Patients who were between 75 and 90 years old and had undergone surgery with a proximal femoral nail (PFN) were included in the study. Patients were excluded if they required general anesthesia, if an acceptable reduction could not be achieved with the PFN, if they did not attend the last follow-up examination, or if the follow-up period was <4 years. Patients were functionally assessed using the Harris hip score at the 6th month and at the last follow-up and using the visual analog scale at the surgery, at the 4th hour after surgery, and at the time of discharge. For radiological assessment, the classification of reduction quality and the measurement of the tip–apex distance were used. Results: Forty patients (22F/18M) were included in the study. Their mean age was 83.0 ± 2.9 years. The mean time from trauma to surgery was 6.8 ± 2.3 h. Patients were mobilized on average 1.53 ± 0.8 h after surgery, and the mean hospitalization time was 27.4 ± 8.1 h. No statistically significant decrease in hemoglobin value was observed before or after surgery (p = 0.476). The Harris hip score was 73.3 ± 3.2 at the 6th month postoperatively and 74.9 ± 2.5 at the last follow-up (p = 0.296). The reduction quality was found to be poor in only two patients. Conclusions: The WALANT technique’s promising results in terms of pain management, blood loss control, and early mobilization show that it is a viable alternative to conventional anesthesia methods in geriatric hip fractures. Full article

Background/Objectives: Anterior redisplacement, defined as a postoperative anterior shift of the distal fragment despite intraoperative reduction, is occasionally observed after cephalomedullary nailing for trochanteric femoral fractures. However, its incidence and associated risk factors remain unclear. This study aimed to determine the incidence of anterior redisplacement following intramedullary nail fixation in geriatric trochanteric fractures, and to identify independent risk factors. Methods: This study retrospectively reviewed data from 598 consecutive hips in 577 patients (aged ≥65 years) who underwent intramedullary nail fixation for trochanteric fractures at a single center (2012–2023). Sagittal reduction on the lateral radiographic view was classified as posterior, anatomical, or anterior according to the position of the distal fragment, and was recorded preoperatively and postoperatively. Anterior redisplacement, the primary outcome, was defined as a change in alignment from a posterior or anatomical position postoperatively to an anterior position on any subsequent follow-up radiograph. Independent risk factors were identified by logistic regression. Results: Among the 543 hips reduced posteriorly (n = 204) or anatomically (n = 339), anterior redisplacement occurred in 73 (13.4%). The incidence of anterior redisplacement was significantly higher following anatomical compared to posterior reduction (19.5% vs. 3.4%; p < 0.001), and also higher in fractures that were anteriorly aligned preoperatively (18.0%) compared to anatomical (8.5%; p < 0.01) and posterior (6.2%; p < 0.01) alignment. Multivariate analysis revealed two independent predictors: preoperative anterior alignment (odds ratio [OR] 1.87, 95% confidence interval [CI] 1.24–2.81; p = 0.003) and postoperative anatomical (vs. posterior) reduction (OR 6.49, 95% CI 2.92–14.44; p < 0.001). Age, sex, Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association classification, Evans–Jensen classification, nail length, and canal-filling ratio were not associated with redisplacement. No lag-screw cutout occurred during the follow-up. Conclusions: Anterior redisplacement occurred in one of seven geriatric trochanteric fractures despite apparently satisfactory fixation. An anatomical sagittal reduction—traditionally considered “ideal”—increases the risk more than sixfold, whereas a deliberate posterior-buttress is protective. Unlike patient-related risk factors, sagittal reduction is under the surgeon’s control. The study findings provide evidence that choosing a slight posterior bias can significantly improve stability. Full article

Background and Objectives: Thailand’s demographic shift toward an aging population increases vulnerability among older adults to the long-term mental health effects of childhood trauma. While childhood adversity is linked to heightened risks of late-life depression and PTSD, the moderating role of resilience remains underexplored in Thai older adults. This study investigated whether resilience moderates the association between childhood trauma and depressive or PTSD symptoms in this population. Materials and Methods: A cross-sectional survey was conducted with 201 older patients (mean age 68.6 years) from the Family Medicine and Geriatric Psychiatry Clinics at Maharaj Nakorn Chiang Mai Hospital. Participants completed validated measures on trauma history, resilience, depression, and PTSD symptoms. A moderation analysis was performed, adjusting for covariates including education, family support, and psychiatric history. Results: The findings revealed that resilience significantly buffered the impact of childhood trauma on depression but did not mitigate PTSD symptoms. Conclusions: These results underscore the protective role of resilience against depression following childhood trauma in older adults, yet also point to its limitations in alleviating trauma-specific responses such as PTSD. This study highlights the need for trauma-informed geriatric mental health strategies and calls for further research on resilience, focusing on cultural context and adaptive mechanisms, including emotion regulation and social connectedness, in older populations. Full article

Background and Objectives: This retrospective cohort study aimed to evaluate the predictive validity of four frailty indices—Modified Frailty Index-5 (mFI-5), Edmonton Frail Scale (EFS), Clinical Frailty Scale (CFS), and Trauma-Specific Frailty Index (TSFI)—in forecasting postoperative complications and functional outcomes in elderly patients with proximal humerus fractures (PHFs) treated either surgically or conservatively. Materials and Methods: A total of 244 patients aged ≥60 years with PHFs treated at Erzurum Hospital between January 2018 and January 2023 were included. Patients were categorized into surgical (n = 110) and conservative (n = 134) groups. Surgical procedures included open reduction and internal fixation (n = 88), hemiarthroplasty (n = 10), and reverse shoulder arthroplasty (n = 12). Frailty was retrospectively assessed using mFI-5, EFS, CFS, and TSFI based on 24-month follow-up data. Outcomes included complications, reoperations, rehospitalizations, and functional results measured by the American Shoulder and Elbow Surgeons (ASES) score. Results: The overall complication rate was 13.1%, with nonunion being the most common. Reoperation and rehospitalization rates were 10.6% and 20%, respectively. The mean ASES score was 71.3 ± 15.2, with 60% of patients achieving good or excellent outcomes. Frailty scores, particularly mFI-5 and EFS, were significantly higher in the conservatively treated group compared to the surgical group (p < 0.01). Across both treatment modalities, patients with higher frailty scores had significantly increased complication rates; however, this effect was more pronounced in the surgical group. Multivariate logistic regression revealed that mFI-5 significantly predicted complications, reoperations, and rehospitalizations (p < 0.001). EFS was associated with reoperation risk (p = 0.018), while CFS and TSFI were not significantly correlated with any of the outcomes. Conclusions: Among the evaluated indices, mFI-5 showed the strongest predictive accuracy for adverse outcomes in elderly PHF patients. Notably, the negative impact of frailty was more evident among surgically treated patients. Routine frailty assessment may facilitate better risk stratification and individualized treatment planning in this population. Full article

Background: This institutional, register-based analysis aimed to evaluate the feasibility of using CT-based sacral Hounsfield units (HUs) for assessing bone density in pelvic fragility fractures and to explore their potential correlation with DEXA measurements and osteological laboratory diagnostics. Methods: Patients aged > 80 years, admitted between 2003 and 2019 with pelvic ring fractures, were analyzed in this retrospective single-center study. CT scans were evaluated according to the classification of fragility fractures of the pelvis (FFPs), which guided treatment decisions (conservative or surgical). The diagnosis of a fragility fracture was based on both fracture morphology and patient history, including the presence of low-energy trauma. Bone health was assessed using standardized laboratory diagnostics including serum calcium, phosphate, alkaline phosphatase, and 25(OH)-vitamin D, in addition to DEXA scans and CT-derived Hounsfield units. Vitamin D levels and bone density evaluations were analyzed to identify possible correlations among these factors and with fracture patterns. Results: A total of 456 patients (mean age 87.3 years, 79.6% female) were included. The CT-based FFP classification identified Type II as the most common fracture type (66.7%). Conservative treatment was the predominant approach (84.9%). Serum 25(OH)-vitamin D deficiency was observed in 62.7% of the patients, while osteopenia and osteoporosis were found in 34.3% and 46.5% of cases, respectively. HU values at S1 showed significant correlation with femoral neck T-scores, highlighting the utility of CT scans for bone density assessment. Conclusions: This study emphasizes the complementary roles of CT-derived HU values and DEXA T-scores in evaluating bone quality and fracture severity in geriatric patients with FFP. While DEXA remains the gold standard, CT imaging offers valuable early insights, supporting the timely initiation of osteoporosis therapy. Given the high prevalence of fragility fractures in this age group, early CT-based screening may facilitate earlier initiation of osteoporosis-specific therapy, including anabolic agents where indicated. Further research is needed to explore the relationships between vitamin D levels, bone density assessments, and fracture types. Full article

Background: The increasing incidence of pelvic ring and acetabular fractures represents a major challenge in the field of trauma surgery. Hemorrhage and thrombosis are among the most severe complications associated with these injuries. The common instability of those fractures, together with an anatomic proximity to blood vessels, increases the risk of perioperative bleeding. Vascular wall irritation during surgery additionally adds to a substantial risk for thrombotic events. Therefore, evaluating the risk for hemorrhage and thrombosis in pelvic ring and acetabular fractures is vital to identify an adequate anticoagulation management. Methods: The incidence of hemorrhagic and thrombotic events, as well as the association of patient characteristics with the investigated outcomes of 16,359 cases, were analyzed retrospectively using data from the German Pelvic Trauma Registry. Moreover, a risk assessment survey was conducted among traumatologists experienced in pelvic ring and acetabular surgery. The results were compared to those of the registry study. Results: A high rate of thrombotic events was found in the middle-age decade (41–50 years). In patients with an age ≤ 40 and >50 years, hemorrhage complications predominated. The logistic regression identified pelvic ring fractures in geriatric patients, acetabular fractures, and Injury Severity Score (ISS) ≥ 16 to be associated with bleeding complications. Factors associated with thrombosis included pelvic ring fractures in non-geriatric patients, acetabular fractures in geriatric and non-geriatric patients, ISS, and male gender. The survey demonstrated that preoperatively, the risk for hemorrhage was considered more significant. Perioperatively, however, thrombosis was regarded as more important. Conclusions: Separate guidelines for prophylactic anticoagulation in pelvic ring and acetabular fractures that also consider individual patient characteristics, such as age, gender, and ISS, are necessary to improve perioperative management and reduce the morbidity and mortality associated with these injuries. Full article

Background: Fragility fractures of the pelvic ring (FFPs) represent a fast-growing entity in geriatric traumatology with increasing incidence worldwide. This study aimed to analyze the epidemiology, treatment concepts, and surgical strategies for FFPs based on data collected by the German Pelvic Multicenter Study Group documented in the German Pelvic Fracture Registry. It is the largest cohort study of its kind. Methods: This retrospective cohort study included patients aged 65 years or older after FFPs, as classified according to the Rommens and Hofmann classification. Data were collected from July 2018 onward and analyzed for demographics; fracture classifications; treatment modalities (operative vs. non-operative); and details of surgery, including timing and choice of implants. Patients after high-energy trauma were excluded. Statistical analyses included descriptive metrics and subgroup comparisons. Results: Among 1242 patients (84% female; median age 83.4 years), FFP Type II was the most common fracture type (50.8%), followed by Type IV (21.1%). Non-operative management was employed in 68.8% of cases, while 30.9% underwent surgery. Surgical intervention was more frequent in higher-grade FFPs (e.g., 72.1% in Type IV). The most common surgical technique for the posterior pelvic ring was percutaneous screw fixation (61.3%), with navigation used in 47.4% of cases. Conclusions: This study highlights the variability in treatment strategies for FFPs, with conservative management predominating in lower-grade fractures and surgical approaches increasingly utilized for more complex cases. The findings underscore the need for standardized, evidence-based guidelines and further research to optimize treatment and long-term outcomes for geriatric patients with FFPs. Full article