Because of demographic change, geriatric patients are becoming a major challenge for traumatology. Multiple trauma patients and patients with proximal femoral fractures are important groups of patients in geriatric traumatology. This retrospective study compares two patient groups with different severities of injuries, and analyzes their patient characteristics and short-term outcomes, focusing on functionality upon discharge. The investigation aims to present the characterizing features of both patient groups, and to identify the potential risk factors for early functionality after trauma. The patient collective comprises two patient groups: a polytrauma group with 91 patients, and a femoral fracture group with 132 patients. Under the control of potential influencing factors, the present study showed no significant influence of belonging to either of the patient groups (multiple trauma or proximal femoral fracture) on the mobility status at discharge. Age, known dementia, pre-clinical intubation, and the lowest Hb value were identified as significant influencing factors. Despite their old age and vulnerability, the majority of geriatric patients survive accidents. Further prospective investigations concerning the maintenance or restoration of functionality after an accident are therefore desirable.

Background: Pilon fractures are severe distal tibia injuries from high-energy trauma, often involving joint and soft tissue damage. Despite surgical advances, long-term outcomes remain poor. This study compared quality of life and functional limitations after surgical treatment of pilon versus tibial shaft fractures using validated PROMs. Methods: This case–control study was conducted at a Level I Trauma Center. Between 2016 and 2019, 84 patients with lower leg fractures were included: 38 pilon and 46 tibial shaft fractures. Inclusion criteria were AO type 42 or 43 fractures and follow-up of ≥24 months; exclusion criteria were polytrauma (ISS > 15), ASA ≥ 3, and incomplete consent. Outcomes were assessed with SF-12, EQ-5D-5L, and VAS-FA. Data were collected 36–48 months postoperatively. Analyses included t-tests, chi-square tests, linear regression. Results: Patients with pilon fractures had significantly poorer physical quality of life than tibial shaft fractures (SF-12 physical: 39 vs. 42, p < 0.05). Mental quality of life showed no significant difference. EQ-5D-5L scores were lower in the pilon group (70% vs. 79%). VAS-FA indicated higher pain and reduced function (total: 64 vs. 76, p = 0.009). Rehabilitation duration correlated with improved VAS outcomes in pilon fractures (p = 0.008), while physiotherapy reduced pain in tibial shaft fractures (p = 0.030). Conclusions: Pilon fractures substantially impair physical quality of life and long-term function, while mental well-being remains unaffected. PROMs provide insights beyond radiological findings and should be integrated into follow-up. Further multicenter studies are required to validate these results and optimize rehabilitation strategies.

Background/Objectives: Patients involved in high-energy accidents (HEAs) are frequently admitted for inpatient surveillance despite normal clinical examination and imaging, although the yield of this practice is uncertain. This study evaluated the frequency and nature of clinical events, interventions during surveillance and missed injuries in such low-risk patients and explored potential predictors. Methods: Retrospective study at a Level I trauma center including patients ≥18 years admitted between January 2022 and September 2023 solely due to HEA mechanism, without apparent injury requiring inpatient treatment. Baseline characteristics, clinical presentation, imaging findings, and laboratory values were extracted. Outcomes included additional diagnostics, new diagnoses, therapeutic interventions, and missed injuries. Patients with eventful and uneventful stays were compared using univariate statistical tests. Results: Among 363 included patients, 86.0% experienced an uneventful stay. Fifty-one patients (14.0%) had an eventful stay, most commonly requiring additional radiological examinations (8.5%) or blood tests (6.9%). New diagnoses occurred in 6.6%, and 6.1% received additional therapeutic interventions. Missed injuries were detected in 3.9%, including two potentially life-threatening injuries (0.6%). No robust predictors for missed injuries were identified. Established predictors of missed injuries from broader trauma populations were absent in this selected low-risk cohort. However, individuals after bicycle accidents were significantly more likely to experience any event during their stay (p = 0.009). Conclusions: Inpatient surveillance of patients without apparent injury after HEAs has a low overall yield but occasionally identifies clinically significant conditions. As no reliable predictors for adverse events were found, selective admission remains challenging. Hybrid models combining short-term observation with structured outpatient reassessment may represent a resource-efficient alternative for low-risk patients.