Fragility fractures and the “season of falls”

Written by Healthy Living News. Posted in Health and Beauty

As we embark upon another long Northwest Ohio winter, we can expect slick, icy conditions to prevail at some point in the season, putting area residents at increased risk of slip-and-fall accidents. For people with strong, healthy bones, a simple slip and fall usually just results in a bruised ego—and, potentially, a sore backside—but for individuals predisposed to fragility fractures, this common mishap can prove to be debilitating or even life-threatening.

As Mercy Health primary care sports medicine physician Jason Smith, DO, puts it, “As we move out of the season of fall, we move into the ‘season of falls,’ which can be a dangerous time for people with low bone density.”

When it comes to treating fragility fracture, Dr. Smith describes his role as handling the “front and back end” of the event, noting, “My focus is on preventing these fractures from occurring and, when they do happen, treating the underlying issues, improving bone health, and hopefully preventing a recurrence.” The in-between phase—the repair of the acute injury itself—is handled by Dr. Smith’s colleague, Mercy Health orthopedic trauma surgeon Seth Phillips, DO.

What exactly is a “fragility fracture”? Dr. Phillips defines it as a fracture that results from a low-energy mechanism—in other words, something that shouldn’t cause a bone to break but does, such as a fall from standing height or less. Osteoporosis is the usual underlying culprit in these fractures, and older women are at the greatest risk of experiencing them.

Dr. Smith says that a female in her 50s who trips and breaks bones is showing a red flag. After a bone density consultation, a patient in that condition will likely show a diagnosis of osteoporosis.

Dr. Phillips explains, “Our bone density peaks when we’re in our 20s and 30s, then plateaus and begins to decline. This is a natural process that happens to everyone as they age. One of the best things you can do is get that peak as high as possible when you’re still young so you’re starting from a higher level of bone density when the decline begins, and you don’t bottom out at a dangerous level.”

With proper treatment, a fragility fracture will heal, but unless the underlying cause is addressed, the individual is very likely to have another one. What’s more, in addition to the pain, discomfort, and other quality-of-life issues associated with the fracture, people who experience a fragility fracture may be at much higher risk of death—not from the fracture itself, but from other medical conditions that can worsen while the patient is recovering, Dr. Smith says.

Dr. Phillips concurs, adding, “If you’re in your 70s and you break an ankle, hopping around on crutches is going to be pretty difficult, so most people in this situation end up in a wheelchair while recovering and may be unable to get around and address their hygiene as well as usual. As a result, any pre-existing medical issues are magnified and become harder to deal with. So, it’s the aftermath of the fall that brings mortality, not the fracture.”

It may be a cliché, but the old saying “An ounce of prevention is worth a pound of cure” certainly applies to fragility fractures. Dr. Smith and Dr. Phillips have many tools at their disposal to help patients prevent these injuries or their recurrence, ranging from medications to lifestyle changes to supplements such as vitamin D and calcium. However, one of the most effective preventive measures they recommend is beginning weight-bearing resistance exercise early in life to help keep your bones as strong and healthy as possible.

Both are also strong advocates of preventive bone-density screening tests (DEXA scans)—especially among the target population of postmenopausal women age 65 and older—to identify developing bone-health issues before they result in fracture. In addition, they can counsel patients on home-safety issues that put them at greater risk of falling, such as loose rugs, clutter on stairs, lack of grab bars in the bathroom, etc.

Measures taken to maintain optimum bone health not only help prevent the pain and potential early mortality associated with fragility fractures, but they can also lead to significant cost savings. “Reducing fracture risk by even two percent across the population, can mean a significant savings in healthcare costs,” Dr. Smith states.

Both physicians share the goal of making it as easy and risk-free as possible for patients to get the expert bone-health treatment and counseling they need, and Dr. Smith emphasizes that much of the care he provides can be done through virtual visits. This offering is especially beneficial to patients at risk of fragility fracture when weather is troublesome during the “season of falls.”

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