During the winter months, cases of hip fracture in the elderlya problem that is dealt with in most urgent cases and that requires numerous material and human resources.
And beyond that, as he points out the point of the Dr. Anton Arrientraumatologist of the IMQ Zorrotzaurre Clinic Bilbao (Vizcaya), the consequences of these fractures for the elderly point directly to their survivalgiven that “a hip fracture in an elderly patient must be operated. The result will not be worse than not doing it. In fact, it has been confirmed that surgical delay in this type of patient is a factor that increases the risk of mortality”.
This specialist emphasizes that in a situation of a broken hip in older people it is necessary to undergo surgery and in general the recovery is positive. “Between 50 and 65% of older people operated on for hip fractures rreturns to previous level of ambulation. Between 10 and 15% walk again, but only inside the house, and the remaining 20% lose the ability to walk inside and outside the home.highlights Dr. Arrien.
The traumatologist pleads for a interdisciplinary approach that “Quickly and completely identify the situation of each elderly patient with hip fracture”as well as developing a effective and fluid communication with the family before the surgical process.
Since like any operation, the surgical approach to hip fractures carries a risk. “Studies show that up to 5% of older patients operated on for hip fractures die in the hospital itself. From there, mortality three months after the operation is 8%, and close to 33% two years after it was performed.”warns Dr. Arrien.
Between 50 and 65% of older people operated on for hip fractures recover their previous level of ambulation
As for the postoperativeDr. Arrien points out that the hospital setting “exacerbates the effects of acute processes and age-related cognitive changes. Changes in the environment, schedules and routines disorient the elderly many times. So much so, that it is proven that the acute confusional syndrome is related to higher mortality in these cases”.
For this reason it is essential proper management of the patient after surgery. “In the postoperative period, attention must be paid to the pain of the elderly, to the wound care surgical, to his correct mobilization (to prevent hip dislocations) and implement a correct prophylaxis of venous thromboembolism”.
Similarly, other complications of operations are “the infections, Although they are not frequent, they are a risk of each surgical intervention, pneumonia, urinary retention, constipation and sarcopenia or loss of muscle mass, which in the case of these recently operated older patients can reach up to a 5% reduction in muscle mass. up to date”.
The prevention of falls, fundamental
Doctor Arrien shows the importance of fall preventionthe main trigger for hip fractures in older patients. “Attention must be paid and action taken on various factors, such as the increase in fragility in the older, alterations of the balancethe presence of Joint pain, alterations of the viewinadequate footwear, obstacles in the home or insufficient lighting”.
It is also important take care of nutrition and keep a adequate level of physical activity; prevention of factors that decrease bone strength; reviewing the prescription of certain medications that may increase the risk of falls and, in general, “act on the modifiable risk factors for osteoporosissuch as weight, nutritional status, lifestyle, toxins such as tobacco and alcohol, and the correct health control of the elderly, among others.