Geriatric fractures or fractures in elderly people is a special category of fractures in adults. These fracture demand a special category because of the unique problems that elderlies have.
With age the bones lose their mineral content and become weak, a situation called osteoporosis. Not only this, there are many medical conditions in the old age that not only make their surgical treatment a challenge but also increase the likelihood of injuries. For example, the presence of syncopal attacks could lead to falling. Similarly, the patient may fall because of poor vision or due to balance problems.
Fragile bones make elderly people prone to injuries with minimal trauma. A trauma that would be tolerated easily in young adults would result in fractures in the elderly. Sometimes, the fractures in the elderly can be caused by routine movements of getting up or bending down.
What are the Types of Fractures in the Elderly?
Due to the weakening of architecture due to osteoporosis, the seniors have a unique pattern of fractures. The bones typically break in the region where they are weaker as compared to some other parts. These are typically areas of cancellous bone and include the proximal humerus, distal radius, spine vertebrae, and hip region.
Hip fractures in the elderly are typically serious fractures and could be associated with high mortality if not treated aggressively to make the patient upright.
A few fractures are more common and typical of old age. These include
- Hip fractures in elderly
- Fracture of distal radius
- Compression fractures of the spine
- Proximal Humerus Fractures
Factors Affecting Treatment Decisions of Fractures in Elderly
Associated Medical Illnesses
Elderly people also have many other problems or medical illnesses. Diabetes, hypertension, cardiac problems, respiratory illness, neurological problems are a frequent accompaniment of old age. Therefore elderly people are at more risk when compared to young adults for any kind of surgical procedure.
The associated medical illnesses may force the surgeon to exercise a treatment option that has lesser risk rather than going for the best treatment.
There are a lot of associated problems too and that makes the fractures in the elderly different category for treatment purposes. As the joints age, they are more prone to get stiff with immobilization. That demands watchfulness and extensive physiotherapy for these persons.
Lesser Demands and Expectations From Treatment
Another factor in the treatment of fractures in the elderly is that they have lesser physical demands, unlike young adults.
With an increase in our understanding of the causes of associated morbidity, newer devices and newer treatment methods aim at the reduction of all these. But still, elderly people are a subgroup of the population who stand the higher risk.
There is a social problem too. Many of the old people are not provided care by their families. Many stay alone because their children have moved to some other place. This frequently results in depression and a lack of enthusiasm to live. We need to have a relook into our social structure.
Most practical is to avoid trauma. This would prevent getting injured and the morbidity that follows. With some simple precautions, one can avoid falling or tripping.
Elderly people should also make an active effort to maintain an active lifestyle and take a good diet.
This would help them to keep a good bone stock for a long time.
How to Prevent Fractures in the Elderly?
Prevention and Treatment of Bone Fragility
Bone mass is related to fracture risk and that bone strength and mass decrease with increasing age.
Alendronate and estrogen replacement are the most effective methods to stop bone mineral loss and consequently reduce the incidence of fracture. Thiazide diuretic is most appropriate in patients with elevated urinary calcium levels.
External Protective Devices
External trochanteric padding and external hip protectors protect against hip fracture but could be cumbersome to wear.
Preventing Injury and Fall
Preventing falls in the elderly needs to target factors that lead to falls.
Falls are very common causes of fractures, especially in old age. With age, bones start getting weak and prone to fracture with the slightest trauma.
With age also come many medical problems, joint stiffness, loss of agility and one tends to fall more often.
First to deal with is osteoporosis itself. Osteoporosis can be improved by taking a good diet in calcium and exercise and if required, medications to increase bone mineral density.
For exercises, one should choose low impact activities like walking, or swimming.
Get Yourself Checked
Get checked and treated for medical conditions.
Avoid medicines can make a person dizzy because that makes one prone to injury.
Be careful and watch steps. Avoid slippery places and choose well-fitting footwear.
Do not rush. Keep the rooms well lit to avoid tripping or misjudging.
Avoid alcohol. It promotes bone loss and could lead to an error of judgment.