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Margaret Thatcher in Hospital: Fractures in the Elderly Often Difficult to Heal
By
David Marsh, Telegraph.co.uk
June
18, 2009
United
Kingdom
These are fractures that occur with minimal force – such as a simple fall – because the bone is weakened by osteoporosis.
Because of the ageing population, the incidence of such fractures is expected to double over the next 50 years.
The most common fragility fractures are of the wrist, hip and spine, but almost any bone can be involved. Osteoporosis-related fractures are estimated to already cost the NHS and social services about £2bn per annum.
Fragility fractures can heal, but they do so relatively slowly. This means that surgical fixation has to be very secure, to hold the bone ends still while they heal and this is a challenge when the bone is soft and implants such as screws can pull out easily. More research is needed to develop implants that perform better in this regard and drugs that will accelerate the healing process. These developments would have great benefit in reducing the impact of fragility fractures on people's quality of life and, especially, independence.
In addition to providing optimal surgical treatment and rehabilitation, it is essential that determined efforts are made to prevent patients from experiencing another fracture.
This secondary prevention has the potential to avoid much suffering, because patients who have had one fragility fracture have at least a doubled risk of sustaining another one and we have good treatments that can halve that risk.
Both osteoporosis and the tendency to fall need to be addressed. If the NHS had been providing such a service over the last few decades, we would be seeing 25 per cent fewer hip fractures now.
The best way to implement this is through a so-called Fracture Liaison Service but, right now, this only happens in about 25 per cent of the cases where it should.
The recent appointment of a Tsar, Keith Willets, for trauma will hopefully give health authorities the necessary push to improve matters.
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