Stress transition and brittle fractures. Prevention and treatment

Prospectively, the growing number of elderly people leads to significant problems in skeletal trauma surgery. Frequently, geriatric patients are provided with total joint replacements in the shoulder, hip, and knee as well as with other extensive metallic implants of the long bones. Partial or subtotal augmentation of the osteoporotic bone with highly stable implants often results in fractures of unprotected bone parts nearby even due to low-energy trauma. There is no doubt that previously inserted prostheses or implants represent an indispensable therapy of the patient's underlying impairment. However, adjacent brittle fractures are an increasing problem in pre-augmented osteoporotic bone. In such situations fracture fixation is a challenge for the orthopedic trauma surgeon.