Elderly Falls: Managing Fractures

Old age, the presence of osteoporosis, an accidental event in the house (stripping, slipping, getting the foot tangled in a rug, a step they didn’t pay attention to, etc.) can cause a fall resulting in serious fractures of the hip, spine and shoulder, which can significantly limit an older person’s activity or lead to surgery.

The first step usually, especially when the elderly person is unable to move or is on the floor, is to call an ambulance to take them to a hospital. There, some x-rays will have to be done and depending on the results, he either returns home with instructions and some treatment, or he is admitted to the hospital, if it is something that requires surgical treatment. And unfortunately, for most seniors at that moment begins a great adventure, often with a bad ending.

The necessity of immediate surgical treatment
“When an elderly person has a fracture, which requires surgical treatment (most commonly hip fractures) the surgery must be done as quickly as possible, because staying in bed for more than 2-3 days results in significant deterioration of the muscular system but also the density of the bones of the elderly person, who, even if he is operated on successfully, finds it very difficult to get up”, emphasizes the Konstantinos Reppas Orthopedic Surgeon, Research Fellow Metropolitan General. And he continues, “the only exception in which a short wait is allowed, before the surgical treatment of an elderly fracture, is the taking of anticoagulant treatment that has usually been given to the patient under specific instructions from the specialist cardiologist”.

Specialized medical team
The organized treatment of a surgical fracture by a special orthopedic team, under specific conditions, is what is needed, so that the elderly can return to their previous state of activity, without endangering their lives. The surgical restoration must be done the same or the next day by a specialized orthopedist. It is necessary to stay in a hospital room with a maximum capacity of three people, who do not face pathological problems such as infections, as well as the correct pre-operative control that includes blood tests and control by an experienced cardiologist and anesthesiologist.

Recovery and return
After surgery, the elderly must return to their familiar environment as quickly as possible. The hospital stay should last no longer than one to two days after surgery, unless there are significant pathological reasons and the patient needs further support. Rapid recovery is necessary, because many times the elderly become disoriented, as even a mild dementia is greatly enhanced in an unfamiliar environment, especially after a long stay in it.

Also, staying in a hospital ward with many people with many different ailments, even of a pathological type, is of course something that should be avoided, as the elderly are susceptible to infections, especially when the general condition is critical due to a serious fracture. The quick return home with the help and support of a physiotherapist, are elements that will support the health of the elderly, leading them to return to their previous activity sooner.

Minimally invasive techniques for quick recovery
“In all this effort, we should not overlook the importance of the technical treatment of a large fracture by an experienced orthopedist, who uses minimally invasive techniques with small incisions and with appropriate materials, which support the patient and help him get up from the very next day of surgery. Advances in anesthesiology using spinal or epidural anesthesia, without the patient receiving general anesthesia, also help in a better outcome,” points out Mr. Reppas.

Therefore, the correct treatment of such a situation, which very often and rightly disturbs the family environment of an elderly person, lies in the choice of the appropriate doctor, who, assisted by a team of doctors (anaesthesiologist, cardiologist or even pathologist), but also by a organized nursing institution, will organize a process, which starts from the early diagnosis and transfer of the elderly until the correct and specific instructions he will receive when he leaves the hospital.
*Note that yesterday, October 17th, has been designated as World Musculoskeletal Injury Day and is dedicated to raising awareness of musculoskeletal injury prevention.

Written by:

Konstantinos Reppas Orthopedic Surgeon, Scientific Associate Metropolitan General

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