Management of Fractures and Degenerative Diseases
Geriatric orthopaedics plays a critical role in managing fractures and degenerative diseases in elderly patients, addressing the unique challenges posed by this demographic. Key strategies include comprehensive geriatric assessments (CGA), multimodal care models, and specialized fracture treatment protocols.
Comprehensive Geriatric Assessment (CGA)
CGA is essential in identifying and managing comorbid conditions, optimizing functional status, and reducing perioperative complications. This approach has been shown to significantly improve outcomes for elderly patients with hip fractures, enhancing their chances of returning to their previous living environments.
Multimodal Care Models
The Special Orthopaedic Geriatrics (SOG) units utilize a multimodal care model that combines preoperative interventions, fast-track surgery principles, and tailored perioperative care. This approach has demonstrated effectiveness in reducing hospital stay durations, readmission rates, and improving rehabilitation times for patients undergoing hip and knee arthroplasty.
Fracture Classification and Treatment
Effective fracture management depends on the type and severity of the fracture. The Garden classification system, for instance, helps guide the treatment of femoral neck fractures by assessing displacement and stability. Non-displaced fractures may be managed conservatively, while displaced fractures often require surgical intervention to prevent complications like femoral head necrosis.
Strategies for Improving Bone Health and Preventing Falls
Ensuring bone health and preventing falls are crucial components of geriatric orthopaedics. These strategies involve medication management, lifestyle changes, nutritional support, and comprehensive fall prevention programs.
Enhancing Bone Health
Preventing fragility fractures involves managing osteoporosis through:
- Medications: Bisphosphonates and other osteoporosis treatments strengthen bone density.
- Nutritional Interventions: Adequate intake of calcium and vitamin D is essential.
- Lifestyle Changes: Regular weight-bearing and muscle-strengthening exercises help maintain bone strength.
Fall Prevention Strategies
Preventing falls requires a multifaceted approach:
- Exercise Programs: Balance and strength training exercises improve stability.
- Home Safety Modifications: Making homes safer by removing tripping hazards and installing grab bars.
- Assistive Devices: Using devices like walkers and canes to enhance mobility.
- Multidisciplinary Approach: Involving physical therapists, occupational therapists, and geriatricians to create individualized fall prevention plans.
By integrating these strategies, geriatric orthopaedics aims to improve the quality of life for elderly patients, ensuring better recovery outcomes and reduced risk of fractures and falls.
Sources
Management of proximal femur fractures in the elderly: current concepts and treatment options
