As the population ages, the incidence of fracture rises dramatically. In fact, by age 85, the risk of fracture is nearly 10 times that of younger adults. With such a high prevalence of fractures in the elderly population, it’s important to have a clear understanding of how to best manage these injuries.
Nonoperative Management of Fractures in the Elderly
There are several considerations that must be taken into account when treating fractures in elderly patients. The first is the patient’s overall health and functional status. An elderly patient who is generally healthy and able to ambulate without difficulty will likely tolerate surgery and rehabilitation much better than one who is frailer and less mobile.
Another important consideration is the type of fracture. Some fractures, such as those involving the hip or pelvis, are much more difficult to treat surgically in an older patient. In these cases, nonoperative management may be the best option. This typically involves using a combination of bracing and physical therapy to help the patient heal and regain function.
It’s important to consider the patient’s preferences and goals when making a treatment decision. An elderly patient who wants to return to an active lifestyle may be more willing to undergo surgery and rehabilitation, even if it takes longer to recover. On the other hand, an elderly patient who is content with a more sedentary lifestyle may prefer nonoperative management so that they can avoid any potential complications from surgery.
Making treatment decisions for fractures in elderly patients can be complex, but it’s important to consider all of the factors and make the decision that is best for both the patient’s function and overall well-being.
Surgical Management of Fractures in the Elderly
Surgical management of fractures in the elderly can be a challenge. The type of surgery depends on the type of fracture and the age and health of the patient. In general, older patients are at increased risk for complications from surgery.
There are three main types of fractures:
1. Closed or simple fractures. These fractures involve only the bone and not the surrounding tissues. They typically require only immobilisation with a cast or splint.
2. Open or compound fractures. These fractures involve both the bone and the surrounding tissues. They often require surgery to clean and repair the wound as well as to stabilize the fracture.
3. Comminuted fractures. These fractures involve multiple pieces of the broken bone. They typically require surgery to realign and stabilise the bones.
Older patients are more likely to have comorbidities that can complicate surgical management of their fractures, such as diabetes, hypertension, and osteoporosis. In addition, they may be taking medications that increase their risk for bleeding or interfere with healing. Surgery may also be complicated by impaired renal function or cognitive decline. All of these factors must be considered when deciding whether or not to surgically treat a fracture in an elderly patient.
I’m here to support you as you go through this. Your well-being is a priority. If you or someone close to you has experienced a fracture, it is essential to get medical aid promptly. Please contact Dr Olivier’s office situated at Vergelegen Mediclinic Somerset West at 021 850 6398 or admin@newlimb.co.za to make an appointment.
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