Decision making in upper extremity problems in the elderly

As life expectancy continues to increase, orthopaedists must become more knowledgeable about upper extremity problems common to geriatric patients. Alternatives to direct repair of certain soft tissue injuries must be considered, because of their diminished healing ability and the morbidity associated with prolonged immobilization. Osteoporosis present in these patients affects surgical management of difficult fractures. Acquired soft tissue disorders such as nerve compression and Dupuytren's contractures often will require operative intervention to improve hand function. Osteoarthritis and rheumatoid arthritis disproportionately affect this age group. A variety of conservative and operative treatments are available to improve quality of life in these patients.