Key points:
- A medical evaluation is recommended starting at age 50 to assess osteoporosis risk.
- Fractures of the vertebrae, wrist, shoulder, and hip are the most common conditions caused by osteoporosis.
- A hip fracture, if left untreated, can lead to serious consequences for the patient.
As people age, common falls become a real health concern for older adults. Dr. Ramón González Pola, orthopedic surgeon at ABC Medical Center, explains that a low-energy fall refers to falls that, under other circumstances, shouldn’t cause harm and that occur from standing height, such as falling out of bed, off a chair, or tripping.
Osteoporosis is defined as a decrease in bone mineral density and is the most common bone disease in people. This condition affects the bone’s microarchitecture, weakening its structural strength, which can lead to an increased risk of fractures.
“Osteoporosis affects men and women of all races and ethnic groups. It can occur at any age, although the risk increases with age. For many women, the disease begins to develop one or two years before menopause.”
In addition, over time, another health issue that correlates with osteoporosis can also develop, sarcopenia, which is the loss of muscle mass, strength, and function in older adults.
The combination of osteoporosis and sarcopenia results in what are known as fragility fractures. These fractures share a common underlying cause, and although surgery or rehabilitation can address them, doctors must evaluate every circumstance to try to prevent them from recurring.
While osteoporosis can lead to a break in any bone, patients prone to fragility fractures generally experience four main types of injury, notes Dr. González Pola:
Shoulder FractureA shoulder fracture can involve the proximal humerus, the upper part of the arm responsible for its movement. In osteoporosis, this fracture typically occurs in adults over 65 and is the second most common type. For treatment, fewer than half of patients require surgery, which involves plates with screws or pins, depending on the specific characteristics of the injury.
If necessary, when the bone quality is very poor, a replacement can be done using a hemiarthroplasty or a reverse shoulder prosthesis, with the goal not only of relieving the patient’s pain but also restoring a full range of motion.
Arm FractureArm fractures are generally linked to wrist fractures, since when a person falls or trips, they instinctively put out their hand to break the fall or impact, which can result in a fracture.
Dr. González notes that, when it comes to wrist fractures in women, around 15% will fracture the distal radius starting at age 50, which is why it’s so important for them to see an orthopedist for preventive care.
These fractures are typically treated with a cast or fiberglass splint, allowing the patient to go about their daily activities without pain or wrist movement. In more severe cases, surgery may be needed to place a plate in the wrist, a procedure known as osteosynthesis.
Vertebral FracturesAmong fragility-related vertebral fractures, the most common are in the lumbar spine, and, to a lesser but still fairly common extent, in the cervical spine or neck, this often occurs in people who have some type of spinal curvature disorder.
Fragility fractures in the vertebrae are called compression fractures, and they occur when the weight of our own body, our muscles, and the objects we carry ends up crushing and compromising the vertebrae. This is the most common type of fracture, occurring in 25% of people over 70, and in 50% of people over 80.
A key risk factor with osteoporotic vertebral fractures is that they can trigger a cycle in which one fracture leads to additional ones happening one after another.
Another important factor to consider is that people who have a vertebral fracture are often asymptomatic at first, but over time they’ll develop changes in posture or breathing.
Depending on the number and type of fractures present, treatment may involve a conservative approach that includes rest, a back brace, and medication. In more severe cases, a procedure can be performed in which a special cement is injected to fill the gaps and help restore the shape of each vertebra.
Hip FractureOf the four most common types of osteoporotic fractures, the hip fracture is the most disabling and typically occurs after a fall. If not treated promptly, it can lead to vascular necrosis, in which the bone tissue dies, posing a serious risk to the patient.
There are generally two types of hip fracture:
- Femoral neck fracture
- Intertrochanteric fracture
These types of fractures usually require surgery, rehabilitation, and medication. When it comes to surgery, there are different treatment options depending on the type of hip fracture and the patient’s condition, ranging from hip repair using screws to total or partial hip replacement.
Dr. González recommends starting regular evaluations at age 50 to assess osteoporosis risk, which can help support a safer, lower-fracture risk lifestyle. It’s important to keep in mind that osteoporosis can’t be prevented, but it can be caught early.
At ABC Medical Center’s Orthopedics and Trauma Center, we can provide you with specialized care. Contact us!
