Archive for the ‘Fracture’ Category
This week I had a patient who has decided that she does not need to treat her Osteoporosis because she does not yet have symptoms. This could be a problem for her. The first symptom of Osteoporosis usually is a Fracture. Ouch!
Actually she has had symptoms. She has 5 Vertebral Compression Fracture Deformities in her thoracic spine. As is usually the case, she had aching, but not sharp pains, from these “crumble-type” fractures. Therefore she doesn’t really believe that they are “real” fractures.
Vertebral Fractures generally occur about a decade before Hip Fractures. They are the early warning that much more obvious, and much more inconvenient, fractures may be coming. You ignore that warning at your peril.
Clinical Osteoporosis is a Silent Disease until the first major Fracture (Bone Attack). Heart disease may be silent until the first Heart Attack. High Blood Pressure may be silent until the first stroke (Brain Attack). Each of these can change your whole life.
Osteoporosis with Fracture is far easier to prevent than to treat – for the patient as well as the doc. Why wait for a fracture? Why not start treatment before ruining your life for a few weeks – or forever.
Take Control of Your Life.
Jay Ginther, MD
Patients, Primary Care Docs, and Orthopedic Surgeons all worry about bone surgery while on Osteoporosis Medications. They also worry about Atypical Fractures of the Femur (AFF). There is one medication that actually helps bone healing and is routinely used to treat AFF. That is the Anabolic, Forteo.
Atypical Fracture of the Femur is quite rare. AFF has become less rare since we started treating osteoporosis with Antiresorptive Osteoporosis Medications. Typical Femur Fractures are still about 100 times as common – and we can prevent over half of those with Antiresorptive Osteoporosis Medications.
AFF is a Stress Fracture, usually just below the hip, that starts on the lateral side of the Femur. It is a small crack, which can gradually spread across the bone.
The best treatment for a stress fracture is stimulating the cells that make new bone (OsteoBlasts) and also stimulating the cells that gobble up bone (OsteoClasts). This increases bone turnover, which is needed for healing a fracture, especially a stress fracture.
Forteo is the only Anabolic we currently have in the USA. Forteo is routinely used to treat AFF before, as well as after, the fracture. It is also used to treat other stress fractures such as metatarsals in the feet and “shin splints” in the proximal shaft of tibia.
Forteo is also commonly used to enhance healing in osteoporotic patients in spine fusions and in total joint replacement.
Jay Ginther, MD
Any fracture, especially after age 50, in a woman or a man, requires a Complete Bone Health Evaluation. This was preached from the podium at the National Osteoporosis Foundation (NOF) meeting last month.
ANY Fracture must be taken seriously. Whether you “fell really hard” on concrete or ice, or fractured in sports, or even if you broke bones in a car crash, ALL Fractures indicate increased Future Fracture Risk.
Studies of injuries in car crashes, after matching passengers for seat positiion, closing speed of the collision, belted or not, tell the story. Those with the best Bone Health are least likely to break. Those with poor Bone Health are much more likely to break.
Age 50 approximates menopause in women, but menopause at any age is more significant than age alone. So are parental fractures, especially of hip or spine. And don’t forget men.
Fractures at any age indicate an increased Fracture Risk. After your first fracture, try to avoid your next fracture by improving your bone health.
Most of us can decrease our Fracture Risk before even considering medications. Enough Calcium, Vitamin D3, Protein, Balance and Strengthening Exercises, go a long way to improve your bone health. This is especially true if you start LONG BEFORE age 50.
Did you fracture? Take Control of your Future. Find what you need to change with a Complete Bone Health Evaluation.
Jay Ginther, MD
Fracture Prevention was the theme at NOF (National Osteoporosis Foundation) this year. This has always been their goal, but it has not been well communicated.
Fractures are bad. Fractures are painful. They keep you from doing things you want to do. For weeks. Or months. Or even forever.
Fractures ruin your finances. They cost a lot to treat. They cost even more if you cannot work.
Fractures can disable you temporarily, or even permanently. You can lose your Independence. You could spend the rest of your life in a Nursing Home.
Clinical Osteoporosis is an Increased Risk of Fracture.
One fracture doubles your risk of a second. Two fractures increases the risk 5 times. Fracture Risk is multiplied 9 times by 3 fractures.
You can decrease Fracture Risk. A Complete Bone Health Evaluation will identify nutrition and lifestyle details that you can improve for better Bone Health.
Many Fractures can be prevented by simple non-medication measures. You can start with proper Calcium, Vitamin D3, Protein, Balance and Strengthening Exercises, Multiple Vitamins & Minerals. These measures are necessary even if you also take osteoporosis medications. Often they alone are enough, at least for a few years.
Take Control of your Future. Prevent Fractures and all the misery they can bring.
Jay Ginther, MD