Doctor, I am a middle-aged lady who slipped and fell in my office lobby as I was walking with my colleague. I was told by the GP that I have no fracture.
How can I protect against having a broken bone from a fall?
It is important to ensure that patients have not sustained any bone fracture after a fall, especially for an elderly person. Sustaining a fracture after slipping and falling is not uncommon in older patients who may already have “weaker” bones. The bones that are commonly injured would be the wrist bones, backbone, ankle bones and the hip bones. These types of fractures occurring in patients with low energy injuries are called fragility fractures.
Elderly patients may have osteoporotic bones which predisposes them to fractures after a low energy trauma such as a fall. An osteoporotic bone is one that has low bone mass density and is structurally weaker. The common causes are aging, vitamin D deficiency and some metabolic conditions like diabetes and thyroid disorders.
The type of fracture sustained depends on the mechanism of the fall and the impact sustained. If someone tries to break their fall by falling on their outstretched hands, it is possible to sustain a wrist fracture. If a person falls on their back or lands on their buttock, it is possible to sustain a hip fracture or a vertebral (spine) compression fracture. Currently, in Singapore, falls among the elderly are the most common cause of hip fractures in patients over the age 60.
We can achieve good bone health by maintaining a healthy lifestyle with regular exercise, healthy diet and cutting down harmful effects on the body like smoking. It is also good to consult a medical practitioner to check if you have osteoporosis. It is also important to check the bone mineral density (BMD) and vitamin D levels as there is medical therapy available for patients who have very low BMD. A low BMD is linked to increase risk of fragility fractures in the elderly.
However, the most important would be the primary prevention of falls among the elderly. Having an appropriate footwear with a good grip, using walking aids and modifying the home environment are some simple steps that we can take to prevent falls. Additionally, some medical conditions like poor eyesight from cataracts and neurological muscle weakness are important contributors to falls among the elderly.
Prepared by,
Dr K Kannan
MBBS (S’pore), MRCS (Edin), MMed (Orth Surg), FRCS (Edin) (Ortho & Trauma), FAMS (Orthopedics)
Consultant Orthopaedic Specialist Surgeon