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December 22, 1956


Author Affiliations


Assistant Orthopedic Surgeon (Dr. Rowe) and Assistant Resident in Orthopedic Surgery (Dr. Detwiler), Massachusetts General Hospital.

JAMA. 1956;162(17):1517-1522. doi:10.1001/jama.1956.02970340007003

• Fractures are an important cause of disability and death in people over 70 years old; they are three times as frequent in women as in men, and more than a third of them are fractures of the hip. The coexistence of other causes of disability must be taken into account in planning surgery, but the elderly patient without serious complicating disease is a good operative risk. Sedation, anesthesia, splinting, casts, fixation, and postoperative exercise should be adapted carefully to the individual case, and sometimes they have a profound effect on the attitude and progress of the patient. In cases of compression fractures of the vertebral bodies, no attempt is made at reduction unless dislocation or facet instability has occurred; the compression is accepted, and excellent results are obtained by a suitable program of physical therapy. The fractured hip, a major problem in the aged, is more successfully treated since the introduction of the three-flanged nail for stabilization. It is important to make use of mechanical aids for early ambulation, to relieve pain, restore weight-bearing, and avoid the complication of stiff joints. Continued, organized help after the patient has gone home from the hospital is frequently essential for complete rehabilitation.