Can an 80 year old undergo surgery for fracture?

Question

Hi doctor,

My grandmother is 80 years old. Her left side is paralyzed. She is incapable of holding or carrying any weight or exerting pressure with her left arm for more than 15 years. Now, she met with a fracture in the same hand. I have attached the x-ray of her left arm. If the fracture and dislocation of the elbow remain uncorrected, will there be any problem? Please advise. Will it fuse or calcify in some position? Now, she is using an arm pouch sling and feeling no pain in her arm.

Answer 1

Hello,

Welcome to icliniq.com.

Thanks for posting your query along with the x-ray image (attachment removed to protect patient identity). Since the affected side is already paralyzed for more than 15 years, there is no point of going through extensive surgery of fixations of distal humerus in 80 year old patient with other comorbidities as well since the functional outcome will remain the same. The bone may not unite in this case as the fracture fragments are intra-articular that is elbow joint is fractured, but even in case of non-union there will be some mobility left at the fracture site. The surgery itself can give rise to complications like non-union, infection and wound dehiscence in addition to the stress of surgery. My recommendation is to continue with arm pouch sling and after three to four weeks start passive mobilization as active mobilization is not possible because of the paralysis.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Keep the arm in sling for three to four weeks for a fracture to consolidate.

Thank you.