Health Matters 11/2: Falls and Fractures: What You Need to Know to Stay on Your Feet

Meelan Patel, M.D.
×
Meelan Patel, M.D.

By Meelan Patel, M.D.

Whether you miss a step coming down the stairs or slip on a wet floor, a fracture from a fall can have serious, life-changing consequences, especially for older adults.

Preventing falls is the first step in avoiding broken bones, but if you do suffer an injury such as a hip fracture, the sooner you get medical help the greater your chances of recovery.

The Hip Fracture Program at Penn Medicine Princeton Medical Center is designed to get hip fracture patients back on their feet faster by ensuring patients undergo surgery and begin rehabilitation as quickly and smoothly as possible.

One Out of Four

More than one out of four older adults – those 65 and older – experiences a fall each year, according to the Centers for Disease Control and Prevention (CDC).

Moreover, the CDC reports that nearly three million older adults are treated in emergency departments for fall injuries each year and at least 300,000 are hospitalized for hip fractures.

The consequences of a hip fracture can be severe, limiting mobility and independence, and even shortening your life.

Not surprisingly, the vast majority of hip fractures – 95 percent – are caused by falls.

A Combination of Risk Factors

The chance of falling – and fall-related problems – increases with age, as older adults typically have more risk factors than when they were younger.

These risk factors may include:

  • Vision problems
  • Lower body weakness
  • Difficulties with walking or balance
  • Taking medication that may cause dizziness or sleepiness
  • Blood pressure that drops too much when you get up from lying down or sitting
  • Foot pain or poor footwear
  • Confusion
  • Slow reflexes
  • Vitamin D deficiency
  • Osteopenia or osteoporosis

Other causes of falls include safety hazards at home or out in the community, such as throw rugs or clutter that can cause tripping or an icy patch on the sidewalk.

Most falls are caused by a combination of risk factors, and the more risk factors a person has, the greater their chances of falling, according to the CDC.

Minutes Matter

When it comes to hip fractures, minutes, hours and days matter.

For older adults, being incapacitated even for a short time can seriously impact their overall health. Consider that the more time an older patient spends in bed, the harder it is to get them up and moving, which impacts their breathing and muscle strength and increases the risk for blood clots, bed sores and other complications.

Additionally, the longer the duration between the injury and treatment, the greater the likelihood of needing strong pain medications, like morphine and other opioids, which can cause serious side effects.

Most everyone who breaks their hip will require some type of surgery. Surgical options depend upon the location, the severity of the break and other factors, such as whether the patient has arthritis and how active they were prior to the fracture.

In many instances, surgeons may be able to repair the fracture using metal screws or a rod. In other cases, a partial or total hip replacement may be necessary. Often, these procedures can be performed using advanced, minimally invasive techniques.

At Penn Medicine Princeton Medical Center, patients who arrive at the Emergency Department with a hip fracture are quickly evaluated by a medical physician, an orthopedic surgeon, and if necessary, a cardiologist to clear the patient for surgery.

The goal is to have the patient medically stabilized and in the operating room within 24 hours of arrival in the Emergency Department.

Following surgery, most patients will be admitted to the Surgical Care Unit or to the Acute Care for the Elderly unit. Discharge planning begins immediately, with the goal to discharge the patient to home, acute rehabilitation or a skilled nursing facility within two to three days post-surgery.

Penn Medicine Princeton Health is a recipient of The Joint Commission’s Gold Seal of Approval® for total hip and knee replacements. It is also one of four New Jersey healthcare organizations and 84 nationwide to earn advanced certification in total hip and total knee replacement from the Joint Commission, the nation’s oldest healthcare accrediting body.

In addition, Princeton Medical Center is rated high performing in hip and knee replacement procedures by U.S. News & World Report.

Stay Strong Against Falls

The best way to prevent hip fractures is to prevent falls. Here are some tips from the National Institute on Aging to help you stay on our feet:

  • Stay physically active. Regular exercise improves muscles and makes you stronger. Mild weight-bearing activities, such as walking or climbing stairs, may slow bone loss from osteoporosis. Activities such as yoga and tai chi can help improve balance.
  • Have your eyes tested regularly. Even small changes in your vision can cause you to fall.
  • Talk to your doctor about the side effects of any medicine you take.
  • Get enough sleep.
  • Limit the amount of alcohol you drink.
  • Stand up slowly. Getting up too quickly can cause your blood pressure to drop, which can cause you to feel wobbly.
  • Be careful when walking on wet or icy surfaces.
  • Wear non-skid, rubber-soled, low-heeled shoes or lace-up shoes that fully support your feet. Do not walk on stairs or floors in socks or in shoes and slippers with smooth soles.
  • Make your home safer. Get rid of things you could trip over, add grab bars inside and outside of your tub or shower and next to the toilet, put railings on both sides of the stairs, and make sure your home has lots of light, including by your bedside and at the top and bottom of the stairways.

Last but not least, be sure to talk to your doctor about whether you need to be screened for osteoporosis, which is often a silent disease until you break a bone.

To find a physician with Penn Medicine Princeton Health, call 888-742-7496 or visit www.princetonhcs.org.

Meelan Patel, M.D. specializes in orthopedic surgery and sports medicine. He is the director of the Hip Fracture Program at Penn Medicine Princeton Medical Center.