• Nike Walter, Dominik Szymski, Steven M Kurtz, Volker Alt, David W Lowenberg, Edmund C Lau, and Markus Rupp.
• Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany.
• Injury. 2023 Jul 1; 54 (7): 110822110822.

ObjectivesThis work aimed at answering the following research questions: (1) What is the incidence of femoral shaft fractures in the geriatric population in the U.S.? (2) What is the rate of mortality, mechanical complications, nonunion and infection, and what are the associated risk factors?Study Design And SettingIn this cross-sectional study, femoral shaft fractures occurred between January 1, 2009, and December 31, 2019, were identified from Medicare records. Rates of mortality, nonunion, infection, and mechanical complications were calculated with the Kaplan-Meier method with Fine and Gray sub-distribution adaptation. Semiparametric Cox regression was applied with twenty-three covariates to determine risk factors.ResultsBetween 2009 through 2019 the incidence of femoral shaft fractures decreased by 12.07% to 40.8/100,000 inhabitants (p = 0.549). The 5-year mortality risk was 58.5%. Male sex, age over 75 years, chronic obstructive pulmonary disease, cerebrovascular disease, chronic kidney disease, congestive heart failure, diabetes mellitus, osteoporosis, tobacco dependence, and lower median household income were significant risk factors. The infection rate was 2.22% [95%CI: 1.90-2.58] and the union failure rate 2.52% [95%CI: 2.17-2.92] after 24 months.ConclusionAn early assessment of individual patient risk factors may be beneficial in the care and treatment of patients with these fractures.Copyright © 2023 Elsevier Ltd. All rights reserved.

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