Why are elderly people prone to fragility fractures?

Written by Su Zhen Bo
Orthopedics
Updated on November 03, 2024
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In clinical settings, elderly individuals commonly experience comminuted fractures, primarily due to their reduced levels of physical activity, which can lead to the loss of proteins, calcium, minerals, and moisture in the bones. This reduces bone strength and density, and if they have osteoporosis, bones can easily break into pieces when subjected to external force. Therefore, it is crucial to apply proper treatment methods promptly after a comminuted fracture occurs. This can involve manual reduction, external fixation, or surgical treatment such as open reduction and internal fixation. Postoperatively, treatments like electrotherapy and physical therapy, along with oral calcium supplements and bone-healing medications, can facilitate recovery. Nutritionally, it is beneficial to consume foods rich in proteins and calcium to aid in the healing of fractures.

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Written by Wang Cheng Lin
Orthopedics
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Why can't it rotate five months after a comminuted fracture of the humerus?

Five months after a comminuted fracture of the humerus, the inability to rotate is due to the lack of early functional exercise post-fracture, leading to severe adhesions in the joint and upper arm muscles, which significantly restrict rotation. This condition can be gradually recovered through later functional exercises, slowly tearing apart the adhered muscles, and increasing the range of motion of the humerus. It is recommended that patients seek rehabilitation treatment in the physical therapy department of a hospital. Additionally, various physiotherapy methods can be used to improve local blood circulation, promote muscle healing, relieve joint and muscle stiffness, and methods such as electrotherapy and magnetotherapy can also be applied to assist in improving the rotational capacity.

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Written by Wang Cheng Lin
Orthopedics
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Post-syndrome of comminuted femoral fracture

The main sequelae of comminuted femoral fractures are as follows: The first is a delay in healing and nonunion of the fracture ends. Due to the comminuted nature of the fracture, local blood circulation has been damaged, and even with surgery, it is difficult to restore circulation. This can lead to delayed healing and nonunion of the fracture ends, generally requiring observation for around one year. If fracture lines are still clearly visible after a year, this confirms a nonunion, necessitating further surgery and bone grafting to restore the healing of the fracture. The second, in cases of nonunion, is the possibility of plate fracture. Many patients, unable to endure extended bed rest, need to start weight-bearing walking. If the fracture ends have not healed and weight-bearing occurs, the body's full weight concentrates on the plate, leading to stress fractures of the plate and screws. Should such stress fractures occur, immediate surgical intervention is needed to replace the internal fixation.

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Written by Lv Yao
Orthopedics
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Post-traumatic sequelae of femoral head comminuted fracture

A comminuted fracture generally refers to a fracture with more than three fragments. When a comminuted fracture occurs in the femoral head, it is also a type of intra-articular comminuted fracture. Generally speaking, after the fracture is reduced and stabilized, there can be some damage to the joint surface as well, leading to unevenness of the joint surface and a higher chance of developing postoperative traumatic arthritis. There is also a possibility that the comminution of the femoral head fracture could affect the blood supply to the femoral head, leading to ischemic necrosis of the femoral head. After treatment for the fracture injury, there will inevitably be some impact on postoperative function. Therefore, after a comminuted fracture of the femoral head, the first sequelae to appear is usually traumatic arthritis, followed by ischemic necrosis of the femoral head, and thirdly, symptoms of restricted movement in the hip joint may occur.

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Written by Li Jin
Orthopedics
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How long will it take to walk after a comminuted fracture of the tibia?

The decision on when to walk depends on the recovery status of the fracture. Generally, a tibial fracture requires about 4-6 weeks of rest. Around 4-6 weeks, you can revisit the hospital for an X-ray checkup. If the callus is growing well, and the fracture line is blurred or disappeared, you can start using crutches to walk and perform functional exercises. However, recovery from a comminuted fracture takes longer, so an X-ray examination is essential before starting to walk. If the examination results show good recovery, then you can start walking. If you walk too early, it may interfere with the fracture healing, and in severe cases, it might even cause the fracture to break again. Therefore, the time it takes for someone with a comminuted tibial fracture to walk depends on the specific circumstances, and an X-ray examination must be performed before walking.

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Written by Na Hong Wei
Orthopedics
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How long does it take for a comminuted patellar fracture to heal?

If the patella is fractured into fragments, conservative treatment is usually not chosen, and surgical treatment is necessary. There are several surgical methods, but as long as the fixation is sturdy and the joint surface recovers well, normal life and work can generally resume in about six weeks. Typically, a follow-up at the hospital is needed in the fourth week or the twelfth week after surgery. If there are no issues at these check-ups, normal work and life can continue. However, the internal fixatives such as steel pins, wires, or memory alloy bone clamps should be removed within six months to a year post-surgery. It is generally recommended that the internal fixation devices be removed around thirteen months after surgery when the patella has healed well, and the knee joint function has been restored, allowing for a return to a normal life. So, for a comminuted patellar fracture, recovery to normal life typically takes about six weeks, and the internal fixation devices can be removed in about a year.