Monday, August 21, 2017

Facing Fragility Fractures

Your doctor may often use the phrase “fragility fracture” when you
experience a broken bone with minimal trauma. You probably
know that experiencing a fracture with normal, healthy, strong
bones is certainly possible. For instance, a child who falls from a
tree and fractures an arm can have normal bone strength, but the
impact is still too great to withstand a break. On the other hand,
people with osteoporosis or other problems, such as osteomalacia
(adult rickets), can develop a fracture without a significant injury.

Hip fractures, vertebral compression fractures, and wrist fractures
all should alert your physician to investigate your situation carefully
and further delve into the possibility of you having lost bone
strength. In infancy, the occurrence of multiple fractures should
alert your pediatrician to the possibility of osteogenesis imperfecta.

Your doctor also may diagnosis osteoporosis if you’re unfortunate
enough to require surgery on a broken bone. During surgery, your
orthopedic surgeon can directly assess your bone quality. She may
call a consultation after the procedure because your bones appear
thin during the operation “like potato chips.” You don’t want to
hear this term when describing your bones, do you? (And to think,
you don’t get any sour cream and chive dip to go with them.)

Increasing evidence suggests that any fracture in women or men
older than 55 can be the first indication of a metabolic bone problem.
Other fractures seen in osteoporosis include rib fractures,
fractures of the arm (humerus), and pelvic bone fractures.

Finally, multiple fractures, even with significant trauma, should
alert your physician to the possibility of a metabolic bone disease
and prompt referral to a specialist.

For example, one of your co-author’s nephews experienced three
fractures over a two-year period while playing ice hockey. His doctors
started him on vitamin D supplements, because he lived in
New Hampshire, where the exposure to sunlight is variable. He
hasn’t had a fracture since!

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