Fracture in Elderly

Compression Fracture
Hip Fracture
Wrist fracture

Compression Fracture

Occure when the normal ustebral body of

the spine is squished or compressed to a
smaller height

Tend to happen to 2 (two) groups :

Traumatic accident
Osteoporosis

Osteoporotic Condition :
Thinning of the bone
Less able to support a load
May develop compression without severe injuries even in
their daily activity

Symptons :
Back pain
Multiple compression fracture
- curring of the spine
- kyphotic detormity
Compressed in front usually normal in back
Spine is curve forward
Loss of overall height
Decreased size of spinal column
Nerve complaints are unusual

Treatment :
Prevention is the best
Alleviating the pain and preventing injuries in the
future
Exercise, calcium and medication
Severe pain
Vertebroplasty
Compression fracture tend to heal completely
8 12 weeks

Hip Fracture
Common injuries in elderly

How do hip fractures happen ?

Fall
Weak bone and Osteoporosis
Other 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 fracture
Intertrochanter fracture

Treatment
Almost always surgery
Non operative treatment :
- stress fracture
- severe medical problem

Femoral Neck fracture

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

Hip Pinning
Several screws across the fractured bone
Well aligned and minimal displaced
Young patients

Hip Hemiarthroplasty
A half of a hip replacement
The ball of ball socket joint is removed
Metal prosthesis is implanted into the joint
Patient with displaced fractured

Hip Replacement Surgery

The ball and the socket would also
replaced
Can be done in patients with pre exiting
arthritis of the hip
Rehabilitation is initiated immediately

Intertrochanter Fracture
Usually repaired with metal plate and
screw
Uses a rod inserted down the center of the
bone rather than a plate a long outside of
the bone.

Wrist Fracture
Most commonly under 65 years of age

How is the diagnosis of a wrist

fracture made ?
Common symptons
Wrist pain
Swelling
Detornity of the wrist

The usual treatment for wrist

fracture :
Most often, broken wrist can be treated in
a cast
Reducing 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 patients
Bone quality
Location of the fracture
Adequacy of non surgical management

Several options for treatment :

Pins
External Fixator
Plate and Screw

Mechanism of Trauma
Hyperextention
Colles 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 Fracture
- This intra articular
- Involve the dorsal margin of distal radius
- Dislocation of the radio carpal joint,

occasionally.
- Fracture line run through the palmar
margin of the distal radius (Volar Barton)

Hyperflexion
Smith Fracture
- Less frequent
- Fall on the dorsum of the hand or from

direct blow to the dorsum of the hand

- Distal fragment is displaced and angled
toward the palmar aspect
- Fracture gap can occasionally extend as
far as radiocarpal joint.