Trauma

International Perspectives

Section Geriatric Trauma of the German Society of Trauma (DGU)
Annual meeting October 27th – 28th 2006 in Münster
Workgroup for fracture treatment in elderly people
AG Alterstraumatologie of the Deutsche Gesellschaft für Unfallchirurgie (DGU) [German Traumatologic Society]

Head: Univ.-Prof. Dr. med. M.J. Raschke
Director Department of Trauma-, Hand- and Reconstructive Surgery - Westfälische Wilhelms Universiaet Münster, Germany
The section of geriatric trauma AG-Alterstraumatologie is a subdivision of the Deutsche Gesellschaft für Unfallchirurgie (DGU) and consists of 58 members from over 20 German clinics of international reputation

In the western civilized world, especially Europe, the proportion of elderly people in relation to younger people will change dramatically. In 2001 the comparison of 60 + year olds to 20-59 year olds yielded a proportional rate of 44/100. The projected rate for 2050 is 71/100. Thus, the treatment of fractures in elderly people will become an issue of paramount importance. In addition, due to the higher level of activity and mobility especially in the elderly population, fracture-rates will rise significantly. The main reason for fractures in elderly people is a combination of osteoporosis and trauma.

The first main goal of the workgroup has been an evaluation of the German “status quo” concerning quality and cost of fracture treatment. These data are used as a basis for improvement and for developing a guideline for health professionals, medical organizations and insurance groups. Another goal is the development of a new classification system for peri-prosthetic fractures which was introduced in 2004. The section of geriatric trauma holds annual meetings during the DGU Congresses where the results of the projects are discussed and new fields of work are defined.

From Sept. 8th – Sept. 10th 2005 the first interdisciplinary congress on Alterstrauma was held under the patronage of Univ.-Prof. Dr. med. M.J. Raschke in the Castle of the University in Muenster, Germany. Over 270 participants attended the congress. Here, trauma and orthopaedic surgeons in combination with geriatricians and politicians discussed prophylactic and therapeutic solutions for treatment of distal radius fractures, proximal humerus and femur fractures.

The second interdisciplinary congress on Alterstrauma was held from Oct. 27th to Oct. 28th 2006 in Muenster. President Prof. Raschke welcomed health professionals, politicians and leaders of insurance groups from all over Europe. The subject of the second congress was focused on injuries of the shoulder and the spine in the elderly population. Participants could exchange experiences and develop new concepts through lectures, workshops and poster presentations. The first presentation was by the President Prof. Raschke about the actual and upcoming demographics of the population in Germany which left no question about the importance of the congress. Prof. Marsh, London UK, Past President of the International Society for Fracture Repair (ISFR), then gave a speech about The Osteoporotic Fracture Campaign. He pointed out the importance of dealing with questions about age, prophylactic concepts and fracture treatment, by stating that every single person will have to deal with these problems one day. Dr. Hoppenheit, commercial director of the University Clinic Muenster, gave a speech about the relevance of an efficient treatment in special context of the financial situation.

The first session was about fractures of the humerus head (chairmen PD Dr. R. Meffert, Muenster and Dr. Seebauer, Munich). It dealt with questions about new implants, minimal invasive approaches and management of osteoporotic fractures. The second session (chairmen Dr. R. Lohmann, Berlin and PD Dr. U. Stoeckle, Berlin) dealt with rehabilitation, prophylactic questions, quality management and research. The next session (chairman Dr. Dreinhöfer – Ulm, Dr. Stöckle – Berlin and Prof. Raschke - Muenster) was titled "Quo vadis ? Round Table". Politicians, surgeons and the director of a major German health insurance company (DAK), gave different statements on the status and future of "geriatric trauma" from their point of view. The second day of the congress started with a session about lesions of the rotary cuff followed by a session about osteoporotic fractures of the spine (chairmen PD Dr. U. Stoeckle - Berlin, Dr. Bullmann, Münster).

The congress rounded off with a patient seminar about degenerative shoulder problems, fractures of the shoulder and rehabilitation which was attended by over 150 patients.