Why are elderly people prone to fragility fractures?

Written by Su Zhen Bo
Orthopedics
Updated on November 03, 2024
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In clinical settings, elderly individuals commonly experience comminuted fractures, primarily due to their reduced levels of physical activity, which can lead to the loss of proteins, calcium, minerals, and moisture in the bones. This reduces bone strength and density, and if they have osteoporosis, bones can easily break into pieces when subjected to external force. Therefore, it is crucial to apply proper treatment methods promptly after a comminuted fracture occurs. This can involve manual reduction, external fixation, or surgical treatment such as open reduction and internal fixation. Postoperatively, treatments like electrotherapy and physical therapy, along with oral calcium supplements and bone-healing medications, can facilitate recovery. Nutritionally, it is beneficial to consume foods rich in proteins and calcium to aid in the healing of fractures.

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Written by Wang Cheng Lin
Orthopedics
1min 16sec home-news-image

How long does it take for a comminuted tibial fracture to heal?

The healing time for comminuted fractures of the tibia generally takes about three months, but it still depends on the method of treatment. Generally, there are two methods for treating a comminuted fracture of the tibia: The first method is conservative treatment, which involves using casts or braces to immobilize the affected limb. Generally, the healing time for this method is about three months. The second method is used when there is significant displacement at the fracture site, such as obvious shortening, rotation, or deformity, which then requires surgical treatment. After surgery, the healing time may take about three to four months. Additionally, severe comminuted fractures can disrupt the blood circulation at the fracture site, leading to poor local circulation and a condition called delayed union, where healing might take about six months. Another scenario involves extremely severe disruption of the blood circulation at the fracture site, leading to nonunion where the fracture ends do not heal together at all. Generally, this requires about a year of observation. If after one year the fracture ends still haven't healed, a second surgery might be necessary. However, for most comminuted fractures of the tibia, the general healing time is about three to four months.

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Written by Li Jin
Orthopedics
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How long will it take to walk after a comminuted fracture of the tibia?

The decision on when to walk depends on the recovery status of the fracture. Generally, a tibial fracture requires about 4-6 weeks of rest. Around 4-6 weeks, you can revisit the hospital for an X-ray checkup. If the callus is growing well, and the fracture line is blurred or disappeared, you can start using crutches to walk and perform functional exercises. However, recovery from a comminuted fracture takes longer, so an X-ray examination is essential before starting to walk. If the examination results show good recovery, then you can start walking. If you walk too early, it may interfere with the fracture healing, and in severe cases, it might even cause the fracture to break again. Therefore, the time it takes for someone with a comminuted tibial fracture to walk depends on the specific circumstances, and an X-ray examination must be performed before walking.

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Written by Na Hong Wei
Orthopedics
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How long does it take to walk normally after a comminuted patellar fracture?

If the surgery is performed without any issues, you can start normal knee flexion and extension exercises about three days after the surgery. Then, about a week later, you can begin walking with the aid of crutches. At six weeks post-surgery, you should return to the hospital for a follow-up. If there is continuous callus formation along the fracture line, you can walk normally. However, you need to be cautious at this time, as the fracture healing is not very solid, and it is best to avoid vigorous activities. Activities like running and jumping should be postponed until about three months later. Therefore, for patellar comminuted fractures, you can generally walk normally between six to twelve weeks after the surgery.

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Written by Cheng Bin
Orthopedics
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Is a pelvic comminuted fracture serious?

For comminuted pelvic fractures, the condition is very serious, demonstrating that the external force involved was quite significant. It causes a disruption in the continuity and integrity of the bone. The patient will exhibit localized pain and swelling, and restricted movement in the affected area. Pressing on the area will produce a distinct bone crepitus or feel, and there might be extensive subcutaneous bruising. For comminuted pelvic fractures, the primary treatment is usually surgical. It is essential to conduct thorough preoperative examinations to exclude any surgical contraindications, and then proceed with the open reduction and internal fixation surgery under general anesthesia.

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Written by Wang Cheng Lin
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Post-syndrome of comminuted femoral fracture

The main sequelae of comminuted femoral fractures are as follows: The first is a delay in healing and nonunion of the fracture ends. Due to the comminuted nature of the fracture, local blood circulation has been damaged, and even with surgery, it is difficult to restore circulation. This can lead to delayed healing and nonunion of the fracture ends, generally requiring observation for around one year. If fracture lines are still clearly visible after a year, this confirms a nonunion, necessitating further surgery and bone grafting to restore the healing of the fracture. The second, in cases of nonunion, is the possibility of plate fracture. Many patients, unable to endure extended bed rest, need to start weight-bearing walking. If the fracture ends have not healed and weight-bearing occurs, the body's full weight concentrates on the plate, leading to stress fractures of the plate and screws. Should such stress fractures occur, immediate surgical intervention is needed to replace the internal fixation.