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Friday, February 23, 2007

Hip fractures affecting the elderly - the chicken or the egg?

In my previous articles about hip fractures which are leading causes of injury leading to death among the elderly, I omitted to discuss one very important question: "Did the fall cause the fracture, or was it the fracture that caused the fall?"

In most cases we will probably never know. A spontaneous fracture of the hip may happen when an osteoporotic person does a slight, slip, stumble or sudden movement. The next thing you know, he or she is lying prostrate on the floor and you have a medical emergency on your hands. Preventing these injuries, be they spontaneous, or be they from a fall is the name of the game. This starts with ensuring that the environment is free of hazards like loose mats, poor lighting and cats or dogs wandering underfoot! Refer to my earlier article and navigate the link to the ACC website for resources about this.

Prevention also means ensuring that bones, muscles, balance and reflexes are kept in tip-top condition regardless of age. The keys are: a nutrient rich diet, plenty of sunlight, regular exercise including agility drills and keeping medications to a minimum.

Osteoporosis and the general frailty often seen in old age can creep up slowly. This can be despite a mostly active life, if one or more of the ingredients such as adequate dietary minerals or vitamin D are not quite sufficient to maintain bone strength. All that it then takes is an illness or injury that stems activity for a few months, or confines the elderly person to sunless rooms and/or a deficient diet and the dyke can burst - a fractured hip for example.

Desperate Housewives is an interesting programme to watch because of the procession of pre-osteoporotic women that parade up and down the fictional Lysteria Lane in their flash convertibles. They are so thin. Ant-like in appearance. Even their facial bones are thinning! They can't be doing enough chewing. I look and wonder how these emaciated stars could ever be role models to the impressionable world? What hope is there for these fragile people when old age catches up with them?

Whether the fall caused the fracture or the fracture caused the fall, the fracture was a long time in the development and the consequences are exactly the same. We must concentrate on prevention.

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