Osteoporosis is a condition which affects millions of individuals worldwide. Unfortunately, once the condition has progressed an individual will often suffer a low impact or low traumatic bone fracture. Most commonly the fractures occur in either the spine, wrist or hip. Once fractured these bones must be set through an open reduction. This means that the bones are brought together and set in surgery.
A hip fracture can present several medical complications because individuals are significantly immobilized after the surgery. The goal of rehabilitation and recovery is to help the individual begin moving well and quickly as possible to avoid serious complications which can happen being immobilized. Immobilization can result in blood clots in the legs which can travel to the heart or lungs as well as decrease muscle strength which will significantly impact the ability of the individual to begin walking again. (1)
Doctors and researchers have found that individuals who suffer from hip fractures do not often suffer from osteoporosis in a vacuum. This means that osteoporosis is generally only one of several medical conditions affecting the health of the individual. Often times hip fractures can also lead to depressive symptoms or cognitive impairments because of the lack of mobility and time spent in the intensive care unit where day and night becomes confused.
In a study published in the Journal of American Geriatrics Society in 2000, researchers measured the problems of depression and cognitive impairment in individuals suffered from hip fracture in order to estimate the effect that these conditions had on their functional recovery and potential death after surgery. Unfortunately, while bone fractures are generally not life threatening individuals who suffer from a fracture related to osteoporosis had a 20% chance of dying within the first year. (2)
The researchers found that cognitive and mood disorders were common in individuals who were elderly and experienced a hip fracture. Unfortunately these conditions were also associated with a greater risk of poor outcomes both independently or combined. This meant that individuals who suffered either depression or cognitive impairment or both had a greater risk of poor outcome. Researchers theorize that by recognizing and treating these conditions they can reduce the adverse outcomes in this population.
Following surgery an individual will have several precautionary treatments ordered dependent upon the surgeon\’s preference, the way in which the surgery was done and the individual\’s overall health. Individuals will be counseled to avoid activities that put a strain on the surgical area and to stop when they feel pain. In this case, there is no need for pain in order to gain strength.
Immediately after surgery an individual will use walking aids, such as a walker or crutches. The amount of weight they are able to bear on the affected leg will depend upon the type of procedure. For procedures using metal plates and pins the surgeon will recommend only toe touch weight-bearing, which means that only the toes touched down on the side where the surgery was done in order to provide balance but no real weight-bearing should be experienced. If a cemented or compression screw was used, physicians will likely give the okay to the patients for a comfortable amount of weight on the foot while standing or walking.
Any exercise after surgery should be done following the instruction of the surgeon or therapist. The kinds of exercise will be dependent on the particular procedure which was done and the overall health of the individual. Once discharged from the hospital the individual will undergo outpatient therapy and be evaluated in their home to ensure their safety. Therapists will review the exercise program and continue to work on walking and strengthening.
cp.hostnine.com/Management of Immobilization and its Complications for Elderly
(2) Journal of the American Geriatrics Society: Depression After Hip Fracture