The fragile bone...and its accompanying 'package' of problems 


Elderly over the age of 60 has an increased risk of getting osteoporotic fractures - fractures that occur after a trivial fall that does not normally fracture bones in young and healthy individuals. These fractures frequently affect (starting from the most common) the wrists, the hips and the spine. Fractures involving the spine and hips unfortunately are associated with increased mortality rate of about 10-20 percent, due to immobility after the injury.

Immobilized elderly may suffer from the following problems :


1. Lung infection - lying down for prolonged periods of time will accumulate secretions in the lungs and this relative stasis may cause bacterial infection in the lungs - resulting in breathing difficulty, fever and, if not treated, septicemia (a condition where bacteria spreads to the blood circulation) and ultimately death. This is one of the most serious problem related to prolonged immobility in elderly.


2. Bedsores - pressure on bony prominences for prolonged periods can cause breakage in the skin that, if infected, will lead to more problems. Pressure sores can affect the heel area, the ankles, the lower back (sacral sore) and also the hip region.


3. Deep vein thrombosis. When we walk, the muscles in our legs help to pump blood from the vessels in the legs back to the heart. Immobilized patients will have a relatively 'stagnant' blood in the vessels of their legs, leading to formation of blood clot called thrombus. This accumulation of blood clots in the vessels of the legs is another serious problem. It presents as swelling of the legs, pain in the calves and worse - dislodgment of these clots into the vessels of the chest, a condition called pulmonary embolism, a commonly fatal complication.


4. Urinary tract infection - infection can also affect the urine and its system. This condition may also cause septicemia in immobilized patients.


5. Muscle atrophy (wasting) from disuse. Muscle needs to be used frequently and repeatedly to gain its strength and bulk. Unused muscles will lose its strength causing weakness, loss of normal muscle bulk and contour. The more wasting these patients have, the time needed to redevelop these muscles will be significantly longer.


Surgery is normally advised for patients suffering from osteoporotic fractures to avoid all these complications. Nevertheless, after-surgery care is essential to avoid the same set of problems and the aim is to get these individuals mobilized as soon as possible.