AB149. SOH25_AB_288. Frailty and hand fractures: is it time for a pathway?

Background: Upper limb fractures from low-velocity trauma often indicate frailty in older adults, stemming from a decline in physiological reserve and function. No specific frailty pathway exists for frailty investigation and treatment in hand fracture cases. This study aims to assess the awareness of specialist plastics/ortho surgeons and hand therapists of frailty intervention (FIT) services and previous utilisation of these services in patients over the age of 65 years. To understand the impact of frailty status on how these groups approach intervention and management of patients in the setting of hand fractures.

Methods: An online survey was disseminated to specialist hand therapists and orthopaedic and plastic reconstructive surgeons. The questionnaire included 16 items assessing respondents’ current practices and frailty management in hand fractures.

Results: The total number of respondents was n=41 (n=21 consultant hand surgeons and n=21 hand therapists) who completed the full survey. Therapists report greater awareness of available frailty assessment pathways and FIT in their working environment (P=0.002). Plastic/reconstructive surgeons reported lower rates of awareness of FIT services compared to their orthopaedic colleagues (P=0.040). Similarly, orthopaedic surgeons reported higher rates of previously availing of FIT services, compared to their plastics counterparts (P=0.01).

Conclusions: Frailty is a significant consideration in managing hand fractures in older adults. However, there is a lack of clear guidance on frailty assessment and referral pathways. Establishing standardised guidelines by hand societies and health services is recommended.

Keywords: Frailty fracture; frailty assessment pathways; frailty pathway; hand fractures; preoperative guidelines