Hip Fractures in the Elderly Can Be Prevented

By: Pamela Egan, NP

A broken hip or a hip fracture is a very common injury, especially in older adults and in the elderly. Broken hips are the most common bone fracture that requires hospitalization. Hospitalizations for broken hips are rising each year to the tune of about 300,000.

Falls are the most common cause of hip fractures in the elderly. High-force injuries such as motor vehicle accidents are the most common cause of hip fractures in younger patients who typically have stronger bones. Pathologic fractures such as weakened bones from infection or cancer can also be a cause of hip fractures.

Usually, osteoporosis is the cause of hip fractures in the elderly. Osteoporosis is a condition that causes loss of bone mass. The bones are thinner and weaker than normal. Adults with osteoporosis are at much higher risk of developing a hip fracture than someone without osteoporosis. The risk of osteoporosis is on the rise possibly due to an overall decrease in hormone replacement therapy and low vitamin D levels. Other risk factors associated with hip fracture are females, Caucasians, and sedentary lifestyle.

There are two types of hip fractures. A femoral neck fracture occurs when the ball of the ball-and-socket hip joint is fractured off the femur. Treatment of a femoral neck fracture depends on the age of the patient and the amount of displacement of the fracture.

Interotrochanteric hip fracture occurs just below the femoral neck. These fractures are easier to repair more often than femoral neck fractures. The usual surgical treatment involves placement of a plate and screws to stabilize the fracture.

Treatment of a hip fracture almost always requires surgery. Some surgeons are using a newer implant that uses a rod inserted down the center of the bone rather than a plate along the outside of the bone. Both types of fracture fixation (the plate and the rod) have shown good healing and have had excellent results.

Physical therapy is usually started immediately and patients can usually walk with their full weight on the implant. Patients are usually encouraged to begin walking immediately following surgery. Most commonly, patients will get up with the physical therapist the next day following surgery. It usually takes a year for full recovery.

Complications often occur in patients who suffer broken hips. By getting patient up and out of bed as soon as possible, the risk of complications is reduced. Mortality rates in the first year following a broken hip are around 25%, and the rates are highest in older populations. The cause of death following a hip fracture is often due to blood clots, pneumonia, or infection. Furthermore, only about 25% of patients who sustain a broken hip return to their pre-injury level of activity. About one year after a patient sustains a broken hip, mortality rates return to normal, but a patient who previously sustained a hip fracture is at higher risk of breaking their hip again.

Treatments for osteoporosis are available, and will help elderly individuals avoid serious complications of this disease such as a broken hip.

An assortment of products are available through medical equipment stores that can help to reduce the risk of the slips and falls that lead to hip fractures. Mobility devices such as medical walkers, rollators, canes and power scooters can help to provide ambulatory assistance to elderly individuals, as well as to those with limited strength or mobility.

Bathroom safety devices can also help to reduce the risk of injury in one of the most dangerous areas of the home for susceptible individuals. Among the most effective of these items are grab bars. Grab bars (also known as safety rails) can be mounted against a wall, inside the shower and on the wall of the bathtub. They provide a gripping surface to help individuals maintain balance and avoid falling down (and ostensibly breaking a hip). Shower chairs provide a seating surface for inside the tub, thereby eliminating the need to stand. This in turn dramatically reduces the risk of slipping while in the shower. Raised toilet seats reduce the amount of bending over necessary for one to assume a seat on the toilet. Finally, non-slip bath mats add traction to the floor of the tub or shower, making it less slippery and subsequently less dangerous.

Lastly, nutrition plays an important role in preventing both osteoporosis and hip fractures. By making a point of getting good nutrition, the risk of osteoporosis and weak bones in general is reduced significantly. The elderly should almost without exception see to it that they are ingesting sufficient amounts of calcium, magnesium and vitamin D3, either through diet or supplements. Since estimating the amount of these nutrients in one’s diet can be so difficult, I receommed going the supplement route just to be sure.

It is important when buying supplements to insist on vitamin D3 (cholecalciferol) as opposed to supplements containing ergocalciferol (vitamin D2). D3 is more readily absorbed by the body, and is a far more effective form of the nutrient in terms of boosting the immune system, preventing disease and improving bone density.

Vitamin D3 and Probiotics Can Help Fight Acne

Vitamin D3, Probiotics are Powerful, Natural Acne Remedies

Acne can result from such factors as hormonal disharmony, bacterial overgrowth, improper eating habits, chronic constipation, heredity and excess oil in the body. Although often overlooked, a direct link exists between Vitamin D and the skin.

Who would have ever thought that Acne was related to an imbalance of flora in the gut or a low Vitamin D level?

If you don’t know me by now, I try to find the cause of symptoms and disease rather than prescribing synthetic medications to cover up symptoms, especially complex acne medications like antibiotics, steroids, and accutane.

Accutane has been linked to Chron’s Disease. Not only does this drug dry up the face, it dries up the whole body. Many times once antibiotics are stopped, acne comes back raging. Sometimes, we just need to take a step back and look at natural remedies that worked in the past.

Vitamin D3 Helps Prevent Acne

Let’s review some simple facts regarding Acne:

Why are more and more adolescents suffering from severe acne? Is it something we’re eating, something we’re taking?

Over the years, our children have received more and more antibiotics for minor ailments. I myself am guilty of demanding antibiotics for my four children when they were younger. My youngest son lived on antibiotics prior to receiving ear tubes. Interestingly, he is the one who has suffered the most with acne.

Many adolescents are treated with antibiotics such as Doxycycline or Minocycline for their acne. The trouble with antibiotics is that while they will indeed kill off the bacteria that may be causing infection, they are non-discriminatory and so will attack the friendly flora in the digestive tract that actually work to keep us healthy. My patients act surprised when I tell them that many elements of the immune system are based the gut.

In a healthy gut, the good bifidobacteria that make up about a third of the gut flora naturally produce antimicrobial agents, which kill off or inhibit the more harmful micro-organisms. When this balance is disrupted and the harmful bacteria are allowed to thrive, they can bind to the gut wall where the damage they cause includes intestinal permeability problems. We fail to absorb the good nutrients, vitamins & minerals and allow the wrong toxins through our intestines. This can lead to nutritional deficiencies, allergies, acne, and auto-immune disease.

The over-prescribing of antibiotics is one of the most common causes of this imbalance. However, supplementing the diet with a good quality probiotic will help re-balance the intestinal system and put those good bacteria back in control. Whenever you are prescribed antibiotics you need to take a probiotic with at least nine strains to counter the negative effects on your digestive system. It is important to note that not all probiotics are created equal. I often prescribe a pharmaceutical strength probiotic with Vitamin D3 for my acne patients.Probiotics Supplements

Even if you suffer from a serious skin condition such as acne, you will likely notice a dramatic improvement to your skin if you take a probiotic supplement. This is because acne has been linked in some studies to intestinal health with researchers reporting increased blood levels of toxins absorbed from the gut in acne sufferers. These toxins come from those pathogens or bad bacteria that take over our intestinal tract. It has been shown that in about 50% of cases of acne, the natural balance of the gut bacteria has been disrupted and the bad bacteria are multiplying faster than the good bacteria. This is referred to as dysbiosis- the disturbance of the natural balance, which is an underlying cause of acne. Probiotics really can make a dramatic and positive difference on your skin.

Although a Vitamin D deficiency does not directly result in acne, obtaining sufficient Vitamin D can help resolve acne by making the skin and body healthier as a whole. Because the sun provides the most potent source of the nutrient, make sure you get enough exposure to the sun to improve your chances of having well-nourished skin. Of course, too much exposure to sun can also cause its own problems, so use your discretion. If your Vitamin D3 levels are low, synthetic forms of the nutrient used in supplements can help with the treatment of several common skin conditions, including acne.

Many clinics are now offering LED Light Therapy which also diminishes inflammation within the sebaceous gland to prevent propions-bacterium (P-acne) from reproducing.

Pamela Egan, NP, ABAAHP Diplomat, CDE is a board certified Adult & Family Nurse Practitioner, American Board of Anti-Aging Health Practitioner, Certified Diabetes Educator, Clinical Specialist in Mental Health can be reached at 985-892-3031.