Osteoporosis: The Silent Bone Loss Behind Hip Fractures
A hip fracture after sixty carries a mortality comparable to some cancers. The bone loss that causes it is painless, detectable and treatable years in advance.
Read articleA fracture is a break in a bone, most often after a road traffic accident, a fall or a farm or workplace injury. Correct early handling — immobilise, do not massage, come straight in — has a large effect on how well the bone and the limb recover.
Symptoms
Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.
- Pain at the injury site that worsens on movement or pressure
- Swelling, bruising and tenderness over the bone
- Visible deformity or abnormal position of the limb
- Inability to use the limb or bear weight
- A wound over the fracture, with or without visible bone
- Numbness, tingling or coldness beyond the injury
When to see a doctor
Do not wait these out
If any of the following applies, arrange to be seen the same day. For anything sudden or severe, call 9281862028 or come straight to the emergency department at SIMS — it is open 24 hours and does not need an appointment.
- Any suspected fracture — attend the emergency department without delay
- A limb that is deformed, cold, pale or numb after injury
- A wound over a broken bone, which carries a high infection risk
- Inability to bear weight after a fall in an older adult, even with mild pain
- Do not apply oil massage, heat or traditional bone-setting to a suspected fracture
Tests that may be advised
Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.
- X-ray in two views of the injured part
- CT scan for complex, joint or spinal fractures
- Assessment of circulation and nerve function beyond the injury
- Blood tests and cross-matching before surgery
- Bone density assessment where the fracture followed a minor fall
How it is treated
Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.
- Reduction of the fracture and immobilisation in a plaster or splint
- Internal fixation with plates, screws or intramedullary nails where alignment cannot be held otherwise
- External fixation for open or badly contaminated fractures
- Wound care, tetanus prophylaxis and antibiotics for open injuries
- Physiotherapy from an early stage to prevent joint stiffness and muscle wasting
- Treatment of underlying osteoporosis after a fragility fracture
This page is general information, not a diagnosis
Fracture can look like several other conditions, and the reverse is equally true. Nothing here can replace an examination, your test results and the judgement of the doctor treating you — and no medicine mentioned by name to a friend or relative should be started on the strength of this page. If you recognise yourself in it, book a consultation with the Orthopaedics department. If a symptom is sudden or severe, call 9281862028.