Hip Fractures and Osteoporosis

Saturday 17 February 2024

Bone fractures in the elderly are almost always caused by weak bones from osteoporosis or a fall. It is common that hip bones are the ones that are fractured. If someone has a hip fracture and wants to be pain-free, he would have to be bed-ridden for 3-6 months. The bone may heal but it could be in a displaced position and he would be unable to walk properly and fall again. Also, staying for prolonged duration in a lying position can cause lung complications, pneumonia, blood clots, bed sores, etc. 

For that reason, doctors prefer hip fractures in elderly to be operated on. Unfortunately, surgery has many risks due to their age. Putting them under anaesthesia is also risky. Further, the elderly may be unfit for surgery if they have blocks in the arteries and their cardiovascular risk for hip replacement is very high.

In such cases, doctors can only pump them with painkillers and blood thinners to prevent strokes or deep vein thrombosis. They would likely need nursing care. It is a financial and emotional strain to their family.

Those who can undergo surgery would have to sit up within 3-4 days and undergo chest rehabilitation to enable them to breath well. By day 5, they have to be transferred to a wheelchair. It would be a very painful process during these 3 months. 

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Osteoporosis is inevitable

Women have a 5 to 1 ratio of suffering fractures, as compared to men. The risk is even higher after menopause as the decline in oestrogen makes the bones thinner. The worst hit areas are the hip joint, end of wrist and spine. Women are advised to build their bone mass to a high level when they are in their 20s to 40s, so that when they reach menopause, the bone mass does not drop to a critical stage.

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Bone renewal is a slow process and has to be combined with proper diet and exercise to work. There's a 40-50% risk of another hip fracture occurring within a year. The anti-osteoporotic drugs take at least 1 year to work. So if your hips are not strong and you are not changing your lifestyle or not doing physiotherapy, then it is going to happen again. Work on building muscles to prevent loss of skeletal muscle mass and strength.

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Some ways to prevent falls

> Have a potty in the bedroom for night-time urination.

> Don't get up from lying to standing position too quickly as it will cause a drop in blood pressure, making you dizzy and fall.

> Install a dim floor light or keep the toilet light on.

> Keep the bedroom free from obstacles so you can move unobstructed.

> Get anti-slip floor mats.

> Remember to take your medications.

(Source: When the hips break, StarHealth, 19/6/2022)

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