Dr Quinton Accone

BSc MBBCH MCFP MBA FC Orth (SA)
Specialist Orthopaedic Surgeon
Practice no. 0411256

A bone fracture is a medical condition in which there is a break in the continuity of the bone.

A bone fracture can be the result of high force impact or stress, or trivial injury as a result of certain medical conditions that weaken the bones, such as osteoporosis, bone cancer, or osteogenesis imperfecta, where the fracture is then properly termed a pathological fracture.

Although broken bone and bone break are common colloquialisms for a bone fracture, break is not a formal orthopedic term.

What is osteoporosis?
Osteoporosis is a disease of porous bones which tend to fracture easily

What are the symptoms of osteoporosis?
Osteoporosis can be present without any symptoms, patient may not be aware of osteoporosis until they suffer from a fracture

What are the consequences of osteoporosis?
Osteoporosis is responsible for considerable pain, decrease in the quality of life and disability, up to 30% of the patients suffer from a hip fracture, and osteoporosis has been also linked to increased risk of death

 

What are the risk factors for osteoporosis?

  • Females in the older age group
  • Thin and small body frame
  • Family history
  • Lack of exercises
  • Diet low in calcium
  • Cigarette smoking
  • Malabsorption syndrome
  • Chronic inflammation due to diseases like rhematoid arthritis
  • Hyperthyroidism
  • Hyperparathyroidism
  • Long term use of blood thinners like heparin and anticonvulsants like phenytoin
  • Patients taking steroids for other aliments like skin problems or asthma

How is osteoporosis diagnosed?

X-rays can detect osteoporosis as the bone appears thinner than normal, unfortunately by the time x-rays detect osteoporosis at least 30% of bone is lost, also x-rays are not accurate indicators of bone density ,DEXA-is the investigation of choice, the test takes about 15 min,exposes the patient to very little radiation and is quite precise, the bone density of the patient is compared with average bone density of same sex and race this is referred to as the Tscoreand is expressed as standard deviation from the benchmark

Osteoporosis-Tscore below -2.5
Osteopenia-Tscore between -1 and -2.5

What is the incidence of osteoporosis?

One in three women will develop a fracture due to osteoporosis in their lifetime , and one in five men will develop a fracture due to osteoporosis.

When should one get DEXA done?
After the age of 50 for screening purpose once in two years Once diagnosed with osteoporosis yearly dexa will help us determine the response to treatment and the need to change drugs If ones parents are diagnosed with osteoporosis the children above 45 years of age should consider screening
If one has undergone a hysterectomy (uterus removal)
If an adult develops a fracture.

What are the common fractures associated with osteoporosis?

  • Hip
  • Wrist
  • Shoulder
  • Spine

What can one do to prevent osteoporosis?

  • Eat a balanced diet
  • Exercise regularly
  • Take adequate amount of calcium and vit D.

What are the treatment options for osteoporosis?
Based on the level of osteoporosis there are 2 basic options one are a group of drugs which maintain your bone mass and prevent you from detiorating these are antiresorptive drugs which can be taken orally once a month or in people who have acidity can be injected once a year, the other drug teriparatide is an anabolic drug which builds bone and hence can improve your bone mass this has to be injected daily.