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Purpose <p>Dens fractures are common in individuals aged 65&#xa0;years and older, with most managed non-operatively. In older adults, these fractures are frequently treated with rigid collars. However, rigid collars have limited evidence base of benefit to support their use and are associated with adverse outcomes. This survey aimed to investigate standard local practices for the management of dens fractures, including the role of the geriatrician&#xa0;in adults aged 65 and over, across major trauma centres in the United Kingdom and Ireland.</p> Methods <p>Clinical leaders at all major trauma centres in the UK and Ireland were invited to participate. The survey collected information regarding the existence of local management guidelines, use of rigid collars, involvement of subspecialty surgical or geriatrics teams, duration of collar use, and standard follow-up practices.</p> Results <p>Responses were received from 29 out of 30 trauma centres, with 28 centres providing complete answers to the survey. 64 percent of centres stated they do not have a protocol or guideline for the management of dens fractures. Results demonstrated considerable heterogeneity in practices across the surveyed centres specifically relating to admission specialty, geriatrician involvement, duration of immobilisation and follow-up.</p> Conclusion <p>This survey provides insights into current variation in practice. This identifies areas for further research and provides a mandate for evidence-based guidelines to standardise practice.</p>

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Management of dens fractures in older people and the role of the geriatrician: a survey of practice in UK and Ireland major trauma centres

  • 期刊论文

  • 发表日期：

    2025年11月20日

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  • Eleanor Thackeray,
  • Rebecca Hutchins,
  • Frances Rickard,
  • Ester Mikova,
  • Mark Baxter,
  • Paul M. Brennan,
  • Emer Ahern,
  • David JH Shipway

摘要

Purpose

Dens fractures are common in individuals aged 65 years and older, with most managed non-operatively. In older adults, these fractures are frequently treated with rigid collars. However, rigid collars have limited evidence base of benefit to support their use and are associated with adverse outcomes. This survey aimed to investigate standard local practices for the management of dens fractures, including the role of the geriatrician in adults aged 65 and over, across major trauma centres in the United Kingdom and Ireland.

Methods

Clinical leaders at all major trauma centres in the UK and Ireland were invited to participate. The survey collected information regarding the existence of local management guidelines, use of rigid collars, involvement of subspecialty surgical or geriatrics teams, duration of collar use, and standard follow-up practices.

Results

Responses were received from 29 out of 30 trauma centres, with 28 centres providing complete answers to the survey. 64 percent of centres stated they do not have a protocol or guideline for the management of dens fractures. Results demonstrated considerable heterogeneity in practices across the surveyed centres specifically relating to admission specialty, geriatrician involvement, duration of immobilisation and follow-up.

Conclusion

This survey provides insights into current variation in practice. This identifies areas for further research and provides a mandate for evidence-based guidelines to standardise practice.