PhD Thesis Highlights Biological Strategies to Improve Fracture Fixation in Elderly Patients

Friday the 19th of December Linnea Arvidsson at the Department of Orthopedics in Lund defends her PhD thesis on wrist fractures in elderly at Lund University with Moroxite coworkers Magnus Tägil and Deepak Raina as scientific supervisors. The thesis explores wrist fractures in older adults through registry, qualitative, and experimental approaches. The registry studies showed that patients with combined distal radius and ulnar fractures experienced significantly worse functional outcomes, and that mortality after wrist fracture in patients aged 80+ was lower than expected, with living situation being the strongest predictor of survival. A qualitative study during the COVID-19 pandemic demonstrated that even very old patients found digital postoperative follow-up both feasible and acceptable.

A central component of the thesis is an experimental study evaluating a novel method to improve surgical fixation in osteoporotic bone — a major challenge in treating wrist fractures in the very elderly. Using an animal model, a combination of a calcium sulphate/hydroxyapatite bone substitute and an anti-osteoporotic medication was applied around fixation screws. This strategy significantly enhanced local bone formation and improved screw anchorage, addressing a key mechanical weakness in osteoporotic fracture fixation. The method was also tested in a small pilot series of hip fracture patients, demonstrating feasibility and promising early results.

These findings suggest that future surgical treatment of distal radius fractures in elderly patients may be improved by biologically augmenting fixation strength. The thesis highlights that age alone is a poor determinant of optimal treatment and that functional capacity, supportive care models, and emerging biological techniques may play a central role in improving outcomes in the oldest patients.