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Dealing with fragility fractures in elderly patients

Fragility fractures caused due to osteoporosis or weak and brittle bones can cause substantial pain and severe disability in older people. Patients usually suffer from fragility fractures in hip, shoulder, wrist and spine due to advancing age.

A fragility fracture is any fall from a standing height or less that result in a fracture especially in elderly people. With increasing age, our bones become weak due to low bone mass and bone tissue loss. This condition is known as osteoporosis. Bone is a living tissue that is constantly being broken down and replaced. Osteoporosis occurs when the creation of new bone doesn’t keep up with the removal of old bone. As a result, many people in their old age suffer from fragility fractures caused in hip, spine, wrist and shoulder.

What is a fragility fracture?

A bone break caused by a fall from a standing height or less especially in elderly people. Elderly people have weak bones due to osteoporosis.

What is osteoporosis?

Bone is a living tissue that is constantly being broken down and replaced. With increasing age and loss of sex hormones, our bones become weak due to low bone mass and bone tissue loss. When this weakness causes considerable loss of bone density, Osteoporosis ensues. This results in more removal and less formation. of bone.

What are the common sites for fragility fractures?

Many people in their old age suffer from fragility fractures caused in hip, spine, wrist and shoulder. A sedentary lifestyle, lack of calcium and phosphate formation in the body, family history and thyroid problems are some of the major causes of osteoporosis leading to fragility fractures in old age.

Fragility Fracture of Hip

A broken hip fracture is probably one of the most common and severely disabling fracture to occur. With more elderly living in developing countries, and it has been estimated that by 2050 half of hip fractures will occur in Asia. The average age of patients with hip fracture is more than 70 years and nearly 80% are women.

Why treatment of hip fracture is important?

Mortality associated with a hip fracture is about 5% to 10% after 1 month in patients who were neglected and patients who refused treatment. Most hip fractures result from a fall or stumble; only about 5% of cases have no history of injury.

What is the right treatment for hip fractures?

Fixing the fracture or replacing it by a half or a total hip replacement is the right treatment. This helps the person to be self independent and prevent complications such as pressure sores, urine infection or chest infection.

Fragility Fracture of Spine

They are almost twice as common as other fractures typically linked to osteoporosis, such as broken hips and wrists. The spine is made of 24 vertebral bones. A vertebral compression fracture occurs when too much pressure is placed on a weakened vertebra and the front of it cracks and loses height. Vertebral compression fractures are often the result of a fall, but people with osteoporosis can suffer a fracture even when doing everyday things, such as reaching, twisting, coughing, and sneezing.

Whats the right treatment of spine fractures?

Pain in spine fractures increase by motion and is relieved by rest. Most people get better by simple methods such as a short period of rest, Limited pain killers and braces to restrict spine movements. In very occasional case, kyphoplasty may be helpful; which is expanding the collapsed vertebra and filling it with bone cement.

Fragility wrist fractures

Osteoporotic wrist fractures are most common in women as compared to men. Wrist fractures are often the first sign of osteoporosis and having a wrist fractures often increases the chances of having a subsequent osteoporotic fracture by 2- 4 folds. Fractures which are not displaced can be treated with splinting, while those with significant displacement require some form of surgery.

What is the general treatment apart from surgery?

The goal of treatment of osteoporosis is prevention. This includes: Lifestyle modifications – regular exercise, smoking cessation, discontinuing alcohol use, and maintaining a balanced diet. Dietary supplementation – current guidelines for patients older than 50 having experienced an osteoporosis-related fracture is 1000-1500mg of calcium and 800-1000iu of Vitamin D daily. Medications that prevent bone loss – include hormone replacement therapy for post-menopausal women or anti-resorptive medications such as alendronate, risedronate, calcitonin , and zoledronate Medication that increase bone production – include teriparatide and denosumab.

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