Managing Osteoporosis and Fractures in Elderly Patients: A Guide - Orthopedics

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Managing osteoporosis and fractures in elderly patients is a critical aspect of geriatric care, especially for those who have experienced falls leading to fractures. In your case, your 85-year-old mother has suffered a fracture due to a fall and has been diagnosed with osteoporosis. This situation requires careful management to ensure her recovery and to prevent further complications.

Firstly, it’s important to understand that osteoporosis is a condition characterized by weakened bones, making them more susceptible to fractures. In elderly patients, falls are a common cause of fractures, particularly in the hip, wrist, and spine. After a fracture, especially in the hip area, the recovery process can be complicated by the patient's overall health, mobility, and the presence of other medical conditions.

Regarding the medications your mother is currently taking—calcium supplements and FORTEO (teriparatide)—it is essential to continue these as part of her treatment plan. Calcium is crucial for bone health, and adequate intake is necessary to support bone density. The recommended daily intake of calcium for older adults is typically around 1,200 mg. If your mother is not getting enough calcium from her diet, continuing the supplements is advisable.

FORTEO is a bone-forming agent that has been shown to be effective in increasing bone density and reducing the risk of fractures in patients with osteoporosis. It is typically prescribed for a limited duration (up to 24 months) due to its potential side effects and the risk of osteosarcoma in animal studies. However, the benefits in terms of fracture risk reduction can be significant, especially for someone with a recent fracture. It is crucial to have regular follow-ups with her healthcare provider to monitor her bone density and assess the effectiveness of the treatment.

In addition to medication, non-pharmacological interventions are also vital in managing osteoporosis and promoting recovery after a fracture. These include:
1. Physical Therapy: Engaging in a tailored physical therapy program can help improve strength, balance, and mobility. This is especially important for your mother, who is currently experiencing weakness and difficulty in walking. A physical therapist can design a safe exercise regimen that considers her limitations and focuses on gradual improvement.

2. Nutrition: A well-balanced diet rich in calcium and vitamin D is essential. Foods such as dairy products, leafy greens, and fortified foods can help. Vitamin D is crucial for calcium absorption, and if your mother is not getting enough sunlight exposure, supplementation may be necessary.

3. Fall Prevention: Implementing safety measures at home can help prevent future falls. This includes removing tripping hazards, ensuring adequate lighting, and possibly using assistive devices like walkers or grab bars in the bathroom.

4. Regular Monitoring: Regular follow-ups with her healthcare provider are essential to monitor her bone health, adjust medications as needed, and address any new health concerns that may arise.

In summary, your mother should continue taking her calcium supplements and FORTEO as prescribed, while also engaging in physical therapy and ensuring a nutritious diet. It is crucial to maintain open communication with her healthcare provider to tailor her treatment plan to her specific needs and monitor her progress. With appropriate management, it is possible to improve her quality of life and reduce the risk of future fractures.