Elderly at increased risk of broken bones

Q. Isn’t a fractured bone less serious than a broken bone?

This is a common misconception. A fracture and a break are the same thing.

For several reasons, seniors are in danger of breaking a bone. As we age, the power of our senses, reflexes and coordination diminishes. Maladies and the medicines we take for them can contribute to balance problems, which can lead to falls. Then there’s osteoporosis, a disease that makes bones more likely to snap.

You may be in danger of having weak bones and should check with a doctor if you smoke, are in poor health, are over 65, fractured a bone after age 50, have a close relative with osteoporosis, are underweight, started menopause before age 45, never got enough calcium, have more than two drinks of alcohol several times a week, or are inactive.

The following are medical conditions that can weaken your bones: hyperthyroidism, chronic lung disease, cancer, inflammatory bowel disease, chronic liver or kidney disease, hyperparathyroidism, vitamin D deficiency, Cushing’s disease, multiple sclerosis and rheumatoid arthritis.

The following also put your bones at risk: oral glucocorticoids (steroids), radiation, chemotherapy, thyroid medicine, antiepileptic drugs, gonadal hormone suppression, and immunosuppressive agents.

Types of fractures

Simple: the bone is broken, but the skin is not.

Open or compound: the skin is broken and may be pierced by the bone.

Transverse: the break is at a right angle to the long axis of the bone.

Greenstick: a fracture on one side of the bone with a bend on the other side. The name comes from the appearance of a broken, young tree branch.

Comminuted: a fracture with three or more bone fragments.

Undisplaced: a break that leaves the bone pieces aligned.

Displaced: a break that leaves the bone pieces out of line.

Most broken bones can heal successfully. Fractured bones usually need at least four weeks to heal, but casts may be removed before that to prevent stiffness, especially for hand or elbow fractures.

The following treatments are used for various types of fractures:

Cast immobilization is the most common treatment. A plaster or fiberglass cast is made to keep the fractured bone in place.

A functional cast or brace permits nearby joints to move.

Gentle traction is usually used to get a broken bone into position.

Open reduction and internal fixation is a type of orthopaedic surgery in which bone fragments are repositioned (reduced) and then held together with screws, by metal plates or rods.

A orthopaedic surgeon can place pins or screws into a bone above and below the fracture. After the bone pieces are positioned correctly, the pins or screws are connected to a metal bar or bars outside the skin. This type of treatment is called external fixation. Eventually, the external fixation device is removed.

Because of the way bones are made, they also get stronger with regular but not excessive exercise. If a person is active, bones will become stronger and more dense. The bones of an inactive person are often not as strong and may fracture more easily than those of an active person. For this reason, older people should try to remain physically active.