Almost every week, I meet an elderly patient with a fracture. Sometimes it’s just a small slip in the bathroom. Sometimes a missed step. Once, I had a patient who fractured her hip just by turning awkwardly in bed. That’s how fragile bones can become with age.
Why is it more complex in the elderly? Well, bones are weaker, as are muscles. Reflexes slow down. Balance is poor. On top of that, most of these patients have diabetes, hypertension, or heart disease. So, the fracture is not the only problem. Anaesthesia is risky. Bed rest is risky. I’ve seen patients get pneumonia, bed sores, even clots in the legs, simply because they were kept in bed too long after a fracture.
The hidden culprit in most of these cases is osteoporosis. Weak bones. Silent until they break. I keep telling families: don’t wait for a fracture to learn about bone health. A simple DEXA scan can show loss early. This can be addressed by engaging in regular exercise and taking calcium and vitamin D supplements. For women after menopause and men over 65, this should be a routine. Sadly, most people in India don’t think of bone checks unless something goes wrong.
Treatment today is far better than it was a decade ago. For hip fractures, we can do joint replacement or fix it with modern implants. Patients can start walking in days. For spinal fractures, we now use minimally invasive techniques, vertebroplasty, kyphoplasty, a needle, a bit of cement, pain relief, and stability. For wrist fractures, small plates and screws allow people to use the hand early.
The big advantage is early movement. That’s key. The faster you get an elderly patient out of bed, the fewer the complications. I’ve seen people in their seventies walk again within a week after surgery. Physiotherapy, rehab, guided exercises, all of it matters as much as the operation itself.
But it’s not enough to fix the fracture. We must treat the whole patient. Control sugar, BP, and heart issues. Prevent falls at home: good lighting, no loose rugs, regular eye checks. Review medicines that cause dizziness. And yes, keep following up on bone density.
Elderly patients need care around the surgery as much as during it.
A fracture should not mean losing independence. With timely surgery, proper rehab, and awareness of bone health, seniors can and do recover. I’ve seen them go back to walking, living active lives, enjoying family. That’s the real goal.
— Dr S Sundar is a senior consultant, joint replacement & tumour surgeon, VS Hospitals, Chennai