gms | German Medical Science

Objectives/Interrogation: Studies in animals suggest that older mice and rats heal fractures more slowly. In adults, as opposed to the pediatric population, the effect of age on fracture healing is unclear. With increasing population age, it is imperative to understand differences in healing according to age for optimal fracture treatment including surgery, immobilization, and therapy.

The purpose of this study was to evaluate metacarpal fractures for age related differences in healing time.

Methods: A retrospective review of patients treated for metacarpal fractures was performed. Patients with incomplete charts or inadequate follow-up were excluded. One-hundred and ninety-eight charts were analyzed. Demographic information and patient factors were documented including background disease, smoking status, hand dominance, and occupation. Fracture characteristics and treatment type were documented. Outcome variables were time to healing and complications. Plain radiographs and clinical examination were used to determine fracture stability and healing.

Results and Conclusions: Age was not associated with fracture healing as a continuous and categorical variable (p=0.09, 0.58 respectively). Minimally displaced and comminuted fractures healed faster than oblique, spiral or transverse fractures (p = 0.05). Patients undergoing surgery healed faster than those without surgery (p = 0.05).

Renal failure was negatively associated with fracture healing p=0.03. Diabetes, hypothyroidism and gender were not associated with healing time.

Complications were not associated with age or other patient or fracture related factors.

Conclusions:

1.

Age does not affect clinical fracture healing/stability in the adult.

2.

Older patients do not require distinct treatment of fractures.

3.

Other fracture related factors and considerations such as functional demand and availability of support systems might influence treatment decisions in fracture care.