Fracture in Elderly

Compression FractureHip FractureWrist fracture

Compression FractureOccure when the normal ustebral body of the spine is squished or compressed to a smaller height

Tend to happen to 2 (two) groups :

Traumatic accidentOsteoporosis

Osteoporotic Condition :

Thinning of the boneLess able to support a load

May develop compression without severe injuries even in their daily activity

Symptons :Back painMultiple compression fracture- curring of the spine- kyphotic detormityCompressed in front usually normal in backSpine is curve forwardLoss of overall heightDecreased size of spinal columnNerve complaints are unusual

Treatment :Prevention is the bestAlleviating the pain and preventing injuries in the futureExercise, calcium and medicationSevere pain Vertebroplasty Compression fracture tend to heal completely8 12 weeks

Hip FractureCommon injuries in elderly

How do hip fractures happen ?

FallWeak bone and OsteoporosisOther risk factors : - Female sex - Caucasion race - Slight built individuals - Limited physical activity

Hip Fracture are generally separated into 2 (two) types of fracture :

Femoral neck fractureIntertrochanter fracture

TreatmentAlmost always surgeryNon operative treatment :- stress fracture- severe medical problem

Femoral Neck fracture

Depends on several factors :- the amount of displacement- the age of the patient

Hip PinningSeveral screws across the fractured boneWell aligned and minimal displacedYoung patients

Hip HemiarthroplastyA half of a hip replacementThe ball of ball socket joint is removedMetal prosthesis is implanted into the jointPatient with displaced fractured

Hip Replacement SurgeryThe ball and the socket would also replacedCan be done in patients with pre exiting arthritis of the hip

Rehabilitation is initiated immediately

Intertrochanter FractureUsually repaired with metal plate and screwUses a rod inserted down the center of the bone rather than a plate a long outside of the bone.

Wrist FractureMost commonly under 65 years of age

How is the diagnosis of a wrist fracture made ? Common symptonsWrist painSwellingDetornity of the wrist

The usual treatment for wrist fracture :Most often, broken wrist can be treated in a castReducing a fracture by specific manuver may be able to realign the broken bone

Which Wrist fracture need surgery for treatment ?Some of the following important consideration determining whether or not surgery is necessary for a broken wrist age and physical demand of the patientsBone qualityLocation of the fractureAdequacy of non surgical management

Several options for treatment :PinsExternal FixatorPlate and Screw

Mechanism of TraumaHyperextentionColles Fracture :- Most common distal forearm fracture- Fall on outstretched extended hand- distal fragment of the radius is impacted and displaced radially and dorsally- Bayonet (dinner fork) deformity - extra articular- located 2-3 cm from the articular surface of the distal radius.- Avulsion of the ulnar styloid

Barton FractureThis intra articularInvolve the dorsal margin of distal radiusDislocation of the radio carpal joint, occasionally.Fracture line run through the palmar margin of the distal radius (Volar Barton)

HyperflexionSmith FractureLess frequentFall on the dorsum of the hand or from direct blow to the dorsum of the handDistal fragment is displaced and angled toward the palmar aspectFracture gap can occasionally extend as far as radiocarpal joint.