Osteoporosis – Bone Fracture | Be proactive – Prevent – Get Treated Immediately
One of the major health risks in the elderly is bone fracture. Bone fractures, however, are the consequences of “Osteoporosis” which is the loss of bone that occurs silently. Often there are no symptoms until the first fall or fracture.
Dr. Sombat Rojviroj, Orthopedic surgeon at the Bangkok Orthopedic Center, Bangkok hospital, explains that human bone is like an egg which has a shell to protect the inside. Osteoporosis is a condition that weakens the shell and makes it more likely to break. When the shell is fragile, its ability to hold what’s inside together will be reduced, which consequently increases the difficulty for treatment.
The leading causes of death in seniors come from cancer, heart disease and brain disease. Whereas, the most common cause of death from accidents in seniors are from falls and injuries such as burns from boiling water. As we age, our brain or the central nervous system that is responsible for our body balance and coordination will gradually decline. In some cases, dizziness may happen when taking some medication, which can also lead to accidental falls.
If patients are associated with osteoporosis, treatment can be quite complicated after a fall. Spinal fractures and wrist fractures are not as fatal as hip fractures. 95% of seniors with hip fractures require surgical procedures. It is reported that within one year following hip fractures, the mortality rate is as high as 20%, while 30% will become paralyzed, 40% may need to use a walking aid and 80% are likely to lose at least one part of their organs. Only 20% will be able to adjust back to normal activities.
During the recovery, patients with hip fractures are required to lie still for long periods of time, which may result in bed or pressure sores and could critically affect how their heart, lung and bladder function. Combined with existing medical conditions and health issues, chances of complications and infections could be increased. Some might develop memory problems such as forgetting where they are, losing track of the time or not recognizing some faces. The treatment could also be quite painful. This cycle of recurrent falls, broken bones and being admitted to hospital could happen over and over again until it leads to death. Some call it the “Vicious Cycle”.
Prevention of osteoporosis bone fractures is vital and can be done by avoiding the risk factors that causes osteoporosis such as steroid intake, alcohol consumption, smoking, being inactive, and unhealthy eating habit. Bone density testing is recommended for all adults, especially those with a family history of fractures. Menopausal women should take a test every 1-2 year. There are a number of different medications used to treat osteoporosis such as calcium and vitamin D supplements or parathyroid hormone injection to increase bone density. However, it is important to consult with your doctor before deciding which medication to take to avoid any side effects.
Dr. Sombat Rojviroj advises that seniors experiencing a hip fracture need to undergo a surgery within 48 hours to cut down the risk of the "Vicious Cycle". An early surgery can lower a chance of a blood clot in deep vein or "Deep Vein Thrombosis (DVT)" and infections, which will improve a chance of recovery.
Falls: Risk Factors among the Elderly
There are two risk factors that should be considered when assessing falls.
- Intrinsic factors refer to patient's illness or health issues including joint disease, cognitive problems or dizziness from a side effect of medication.
- Extrinsic factors refer to environmental factors that increase the risk of falling such as wet or cluttered floors and uneven floor surface. Enough lighting and the grab bars or handrails should be installed for seniors between their bed and the bathroom as a fall often occurs at night when they need to use the toilet.
Questionnaires can be used as a risk assessment. For example, patients will be asked if they have fallen in the past year or feel imbalanced while walking. Patients can have their balance and coordination checked by the Balance Master machine. Hip and knee exercises are highly recommended to strengthen and stabilize the joints and muscles in those areas. Walking and jogging can be done for those without any hip or joint problems. However, those associated with the degeneration, swelling or inflammation of hip bones or joint diseases are advised to have water therapy exercises or consult with a physical therapist for appropriate exercises.
Tips: Fracture Treatment with Minimally Invasive Plate Osteosynthesis (MIPO)
The Minimally Invasive Plate Osteosynthesis is a recommended surgical procedure as it offers better results with minimal complications. This technique involves a small incision above the fracture site, and utilizes specialized equipment to insert a metal plate to be held in place with screws above and below the area. The goal is to cause as little damage to surrounding tissues as possible. The size of the incision is far smaller which results in less bruising, allowing a faster recovery period, and less chance of complications such as infection, or the need for repeat surgery. For enhanced accuracy, the doctor will use a fluoroscope X-ray to ensure proper alignment. This is an imaging technique that uses X-rays to obtain a real-time moving image, which allows the physician to see the internal structure of the patient.
5 Keys for Minimally Invasive Plate Osteosynthesis
- To align the bones in accurate positions.
- To stabilize fractures through the locking compression plating method.
- To provide as little damage as possible to surrounding tissues and blood circulation around the fractured area.
- To use in a case of hip replacement.
- To provide fast recovery period. No plaster cast required.
At Bangkok Orthopedic Center, Bangkok Hospital, we have a team of experienced Orthopedic specialists ready to provide 24/7 consultations and treatments for patients with fractures and with post-fractures. Patients can be confident that you will receive instant professional care and treatments with the highest satisfaction guaranteed.
For consultations, patients can send the X-Ray images to e-mail: BFC@bgh.co.th
Fast Track Fracture Call Center Tel. 1719