Treatment of Frail Elders with Fractures

by admin-blog-kh | May 12, 2021 1:54 pm

Falls are the bane of the elderly. The risk of a fall related injury in people aged 65 and above is indeed a cause for concern. Falls are the most common reason for the elderly suffering from fractures. In addition to this, the elderly usually have other health complications as well. Hence, if they suffer a fracture, special care has to be taken during treatment.

A fall might result in a fracture, but it is not the only cause of fractures. They can also be caused by road traffic accidents and continuous strain on certain parts of the body. The latter is more common among sportspeople and is called a stress fracture[1]. Osteoporotic changes also make people more prone to fractures[2].

Geriatric Care[3]

What Is a Fracture?

When the bone breaks partially or completely, it is called a fracture. In senior citizens, falls need not necessarily have to happen from a great height to cause a fracture. When the fall happens from standing height or lesser and results in a fracture, it is called a fragility fracture. These fractures usually affect the following parts:

• Hip
• Spine[4]
• Wrist

 Treatment Options

The treatment decided on will depend on the part of the body that has suffered a fracture and the severity of the fracture. The doctor will consider the pros and cons of both surgical and non-surgical treatment options as well as the patient’s preferences before deciding on a suitable course. Below are listed the possible treatment options:

• Cast/Splint: A cast keeps the bone aligned and helps prevent further movement of the injured area. It protects the area while it heals. A splint is not as confining as a cast and is hence also referred to as a half cast. Doctors sometimes might use a splint and cast both. A splint will be used initially to secure the bone, and later it might be replaced with a cast.
• Traction: Here, the body parts are gently stretched in a particular direction. During traction, the muscles and tendons around the fracture are stretched so that the bones are positioned properly and heal. Traction uses a system of a pulley with weights to set the bones.
• Surgery: A surgery is performed either under general or regional anaesthesia when the doctor feels that the other treatment options will not be effective. It is also done when the bone does not set properly after a cast. Surgery typically involves the usage of metal rods, plates, and screws to position the bone properly.

A few points to keep in mind after surgery:

• The recovery duration might be anywhere between 6 and 8 weeks. This again depends on the severity of the fracture, fractured part, etc.
• The duration of hospitalization after surgery too will depend on the above-mentioned factors.
• Pain after surgery is to be expected. Your doctor will help in pain management[6] by suggesting various techniques to reduce pain and by giving painkillers.
• Make sure to keep the area of surgery clean and dry.
• If there is any evidence of the injured area taking a turn for the worse, like pus or swelling, the doctor needs to be informed immediately.

The goal of all the treatment options is to help the patient regain movement as soon as possible. Once that is accomplished, the doctor will look into ways to prevent another fracture from occurring. A physiotherapy[7] program will also commence when the doctor thinks it is advisable.

Caring at Home

Prepare the home in advance so that care for the recuperating elderly becomes easier for him/her and you. Here are a few pointers:

• If their room is not already on the ground floor, it would be wise to move them there. Climbing stairs while they are recovering is not advisable.
• Make sure they eat healthy food. They might not be able to cook immediately after surgery. Understand this, and plan for it in advance.
• Clean the house so that they can have an infection-free recovery.
• Handrails can be installed in areas where they have to lift themselves.
• It is very important that they are able to contact you for assistance during times of need. Make sure there are proper means for this.

Fracture Prevention

It is a fact that the elderly take a longer time healing from fractures than younger adults. Hence, it is in everyone’s best interest to prevent fractures. Below are listed a few steps that can be taken to prevent fractures from occurring.

• Keep bones in good condition by making sure you have enough calcium intake. Adults over 40 years are recommended daily calcium intake as follows:
• Calcium intake for men: 1000 mg
• Calcium intake for women: 1200 mg
• Avoid medications that cause drowsiness or take care not to use them when you need to perform some activity.
• Strength training exercises take up a pivotal role in keeping bones sturdy.
• In addition to this, weight-bearing exercises should also be performed.
• Your genes do play a part in bone strength, but diet and exercise can overcome any genetic weakness.
• Your Orthopedician[9] can help with a proper yet practical diet and exercise program.
• Get regular eye check-ups.
• Wear footwear that is comfortable and gives a good hold.
• Wires should not be on the floor and should be secured properly.
• Hand rails can be installed where you feel necessary (like in bathrooms).
• Make sure the house is well lit. Switches should be in easily accessible places so that the lights can be turned on before you walk to your destination during night hours.
• Mats, carpets, and the like should either be secured well or dispensed with altogether.
• Practice yoga. It will help with balance issues.
• Do not feel embarrassed to use a cane.

 

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

Chennai – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801

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