Posts Tagged ‘Fragility Fracture’
Sometimes a person breaks a hip first, then they fall. ¬†This happens a lot more often than we realize. ¬†When the break is just below the ball of the hip, the fracture may have come before the fall. ¬†Moreover, that Fragility Fracture may have gradually developed over days or weeks.
How is it possible that a person does not realize that the hip is gradually crumbling? ¬†We call it a Stress Fracture when a crack gradually developes. ¬†Small cracks gradually getting bigger are usually not recognized until they are completely across the bone and it breaks, causing the patient to fall. ¬†Why?
The aching pain of a stress fracture is often too gradual to distinguish from arthritis pain until the break is complete and the whole bone collapses. ¬†The best way to see this process is to watch a video of the I-35W bridge collapsing in Minneapolis on 1st August 2007.¬† http://search.yahoo.com/search?ei=utf-8&fr=aaplw&p=i35w+collapse ¬† Tiny cracks slowly developed in the steel until one day……..THUD!
How can you detect who is at high Hip Fracture Risk? ¬†A very low DXA T-score, especially in the spine, is a good indication. ¬†But DXA often fails¬†if the spine is already crumbling or has arthritis. ¬†A better indication is Vertebral Fracture Assessment (VFA). ¬†Looking at the spine from the side,¬†Vertebral Compression Deformities can¬†indicate crumbling spongy bone in the spine before the spongy bone in the hip also crumbles.
Know where you stand. ¬†Get a Complete Bone Health Evaluation. ¬†Take Control of your future.
Jay Ginther, MD
Recently a patient finished her half hour visit by saying, “so there is nothing you can do for me”.¬† We had discussed Low Bone Mineral Density (BMD) on her DXA; Vertebral Compression Fractures on her VFA; correcting her Diet – Low in Calcium, Vitamin D3 and Protein; Cutting Down her Smoking; back extension Exercises; and possibly Medications that could reverse her Clinical Osteoporosis.¬† None of these interested her.
She was not interested in what she could do to prevent future fractures.¬† She wanted me to “delete” her current Fragility Fracture and¬†the problems she was having from it.¬† She did not believe that she has clinical osteoporosis.¬† She did not believe she is at risk for future fractures.¬† She certainly did not believe that she should be expected to take any action to help herself.¬†
Aunt Henrietta looked like half a raccoon with her entire left eye blackened. ¬†She¬†dismissed her looks as not a problem saying, “I fall all the time, but I don’t break anything.” ¬†This is a change on both counts. ¬†Five years ago, falls were infrequent. ¬†Even so, she broke one wrist, then the other wrist, then her shoulder.
Two wrists, one shoulder, and half a dozen vertebral fragility fractures indicated Very Severe Osteoporosis. ¬†That was before she took the Anabolic, Forteo, for 2 years. ¬†She was the ideal patient for serious measures to stop her fractures. ¬†And it has worked!!
A Hip Fracture over age 70 is Very Bad. ¬†About 20% of women and over 30% of men die from their hip fracture.¬†¬†Some consider these to be the lucky ones. ¬†Nearly half of those who survive a hip fracture spend the rest of their lives in a nursing home.
Many hip fractures should be preventable.¬†¬†There were warnings!¬† Half of the people who break a hip had another Fragility Fracture a few months or years before.¬†¬†Most warnings go unheeded.¬†¬†Hip Fractures that could have been prevented destroy quality of life for too many individuals.