Preventing hip fractures in the elderly

Written by: Professor Xavier Griffin
Published: | Updated: 08/01/2021
Edited by: Cameron Gibson-Watt

Hip fractures present a huge challenge to older people and healthcare systems. That is why fracture prevention strategies are so important in their overall care.


In this article, Professor Xavier Griffin, a top consultant trauma and orthopaedic surgeon based in London, Oxford and Banbury, explains the measures that should be employed to prevent hip fractures in older people.

 

 

Why is preventing hip fractures so important?

Hip fractures are a significant issue for older people and their recovery is often complicated. It presents a huge challenge to both the healthcare system and their families, requiring a coordinated multidisciplinary approach that extends far beyond the operating room.

 

Unfortunately, older people can develop life-threatening complications both during and after hip surgery, such as blood clots, infections and irregular heart rhythms. So, with the burden of these health problems and now the additional risk of contracting COVID-19, the real challenge lies in prevention. It is therefore important to employ effective prevention strategies to improve the quality of life in this group of patients.

 

How can fractures be prevented?

Two main fracture prevention strategies are employed: Reducing the risk of falls and improving a person’s bone health.

 

  • Reducing the risk of falls

Older people should be assessed to identify any medical causes that might result in falling. Conditions include postural hypotension, syncope and irregular heart rhythms. Basic investigations should be coupled with a clinical assessment, such as lying and standing blood pressure and a 12-lead ECG, and a regular review of current medications. Mechanical causes for falling such as poor mobility, balance and impaired vision should also be assessed. A home assessment should also be done with modifications made if needed.

 

  • Improving bone health

If a patient has low bone density or osteoporosis, it can significantly increase their risk of fracture. Bone density tests are therefore recommended for older people at risk of fractures.

 

Exercises can also maintain muscle strength and reduce the risk of slipping and tripping up. Likewise, a diet that provides enough calcium and vitamin D is equally important.

 

How can you fall-proof your home?

Most falls in older people occur in their own homes. There are, however, easy changes that can be made to significantly reduce your risk of tripping up and slipping over objects:

 

  • install rails and grab bars, suitable bathroom equipment and a stairlift
  • remove loose rugs
  • replace rugs with non-slip mats
  • improve the overall lighting
  • keep the floors and staircases clutter-free
  • wear comfortable and well-fitted shoes

 

What type of exercises are effective?

Moderate exercise is important to slow bone loss, maintain muscle strength and improve balance and co-ordination. Balance training has been shown to reduce the risk of hip fractures. Other good exercises include:

 

  • swimming
  • yoga
  • tai chi
  • working with resistance bands
  • weight lifting

 

Which tests and medications can be offered?

To help ensure that your bone health is maintained, a bone health profile can be obtained through routine blood tests to identify calcium or vitamin D deficiency. People aged over 50 years and men should consider if they need to supplement their calcium and/or vitamin D intake. This can be achieved from a combination of a healthy diet and supplements.

 

Furthermore, osteoporotic fractures can be prevented with medication such as oral bisphosphonates, which can slow bone loss and reduce fracture risk. This should be considered for postmenopausal women over 75 years of age and in younger people who have been diagnosed with the condition.

 

Despite the global scale of the problem and the huge impact of sustaining a hip fracture on a patients quality of life, our understanding of this challenging injury is still very much evolving.

 

If you are worried about your bone health and would like to find out more about your bone health and fracture risk, you can make an appointment with Professor Xavier Griffin through his Top Doctors profile.

By Professor Xavier Griffin
Orthopaedic surgery

Professor Xavier Griffin is a leading consultant trauma and orthopaedic surgeon based in LondonOxford and Banbury. He holds the inaugural Chair of the new clinical and academic collaboration in orthopaedic surgery at the renowned Barts and The London School of Medicine.

His areas of expertise are broken bones and muscle injuries in adults and children, hip replacements, and hip reconstruction following traumatic injury. He is a national specialist in the treatment of severe injuries of the pelvis bone and hip socket. He is currently based at the Nuffield Health Oxford Manor Hospital, The New Foscote Hospital and Royal London Hospital, Barts Health NHS Trust.

After completing his undergraduate degrees at Cambridge and Oxford Universities in 1999 and 2002, Professor Griffin went on to do ten years of trauma and orthopaedic training in both Bristol and West Midlands. Following this he underwent internationally recognised fellowship-level training at the Royal Melbourne Hospital, Victoria, Australia. He was trained by world-leading experts in the treatment of broken bones and hip replacement, particularly in the treatment of the pelvis and hip socket.

For his PhD, Professor Griffin investigated the causes of pain in musculoskeletal disease and to date he leads on the conduct of nationwide research studies and clinical trials. He is also involved in education, supervising students working towards training in orthopaedic surgery.

Professor Griffin is offering virtual consultations as well as traditional face to face appointments. He acts as expert witness and is accepts instructions from solicitors across the UK. Please contact his office for more information.

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