An osteopathic fracture is any fracture that occurs as a result of osteoporosis, a disease which affects the bone density of aging individuals. There are no specific symptoms for osteoporosis — it is known primarily for the resulting increase in risk for fractures, which can be quite dangerous for an elderly person. Osteopathic fractures occur most commonly in the hips, ribs, wrists and vertebral column (along the spine). They may have serious consequences, often leading to acute and chronic pain, further disabilities, or even early mortality in the most severe cases. When bones are fractured as a result of osteoporosis, particularly the hip bone, mobility will be severely impaired and surgery may be required to avoid serious conditions such as pulmonary embolism, vein thrombosis or even death. Patients may be at higher risk of osteoporosis and related fractures based on factors such as age, alcohol and tobacco usage, body mineral density, gender and weight.
The disease known as osteoporosis is characterized by bone mass deficiency and destruction of bone tissue. As osteoporosis continues, it leads to weaker bones that break much more easily, particularly in the wrists, hips and spine. There are more than 10 million people over the age of 50 currently suffering from osteoporosis in the United States alone. Women are affected four times more often than men, primarily because of the decrease in estrogen during and following menopause, when women may lose as much as 20 percent of their bone density. In addition to osteoporosis sufferers, there are also 34 million people in the United States over the age of 50 with low bone mass, which puts them at risk for osteoporosis and osteopathic fracture.
Osteoporosis can generally be categorized either as primary or secondary, depending on the supposed causes and risk factors:
- Primary osteoporosis – When osteoporosis is caused by bone loss due to aging (patients over 70), it is considered primary osteoporosis. This type also includes cases in which the patient is under the age of 70 and the cause is unknown.
- Secondary osteoporosis – When osteoporosis is caused by diseases, lifestyle factors, and/or medications, it is considered secondary osteoporosis. There are typically several risk factors involved when the condition develops this way.
Since individuals suffering from osteoporosis have a lower bone density, they are more sensitive to fractures even from the mildest slips and falls. Elderly people are already more likely to have these types of accidents because of balance disorders, impaired vision, movement disorders, postural collapse and other factors associated with aging, so the risks are high. Osteoporosis sufferers who have already had serious falls are at even higher risk of recurrent fractures.
Women are at particular risk for osteopathic fractures, so it is important for women over the age of 50, particularly Asian and Caucasian women, to visit the doctor frequently to review their lifestyle practices and develop a plan to reduce the risk factors for osteoporosis and prevent related fractures. Measurements of height and weight, as well as assessment of risk for fractures resulting from slips and falls, should be scheduled annually after a woman has been going through menopause for at least a year.
There are no symptoms of osteoporosis itself, but there are often very acute symptoms of the fractures that are commonly attributed to this condition. In other cases, osteopathic fractures have no marked symptoms, at least not right away. Vertebral collapse, also known as a compression fracture, is the most symptomatic fracture caused by osteoporosis. The most common osteopathic fracture symptoms include the following:
- Chronic pain
- Loss of height
- Pain in the bones and muscles
- Radiculopathic (shooting) pain
- Reduced mobility
- Stooped posture/deformed spine
- Sudden back pain
The most common osteopathic fractures are related to primary osteoporosis, associated with the following risk factors:
- Bone density/weakness
- Family history
- Gender and race (Asian and Caucasian women are at higher risk)
- Lifestyle factors including alcohol, caffeine, certain medications, deficiency of calcium and vitamin D, physical inactivity and smoking.
Secondary osteopathic fractures are almost all related to lifestyle factors and the development of other diseases and conditions, including the following:
- Ankylosing spondylitis
- Chronic obstructive pulmonary disease
- Cystic fibrosis
- Decreased testosterone levels
- Excessive use of alcohol, caffeine and/or tobacco
- Gastrointestinal disease
- Neoplastic disease
- Osteogenesis imperfecta
- Rheumatoid arthritis
- Systemic mastocytosis
- The use of glucocorticoid medications, anticonvulsant medications and various immunosuppressive drugs
Since many of these osteopathic fracture symptoms are similar to the symptoms of other bone disorders, medical conditions and diseases that commonly occur in elderly patients, it is important to get an accurate diagnosis from an expert physician. A physician can look at a patient’s personal history, complete medical and family history, perform a comprehensive examination and complete a number of tests to more accurately diagnose the condition. Blood tests and skeletal X-rays are often necessary to further examine the potassium and calcium levels, bones, organs and internal tissues. There are also bone density tests that measure bone mass and volume to assess for risk of future osteopathic fracture. Fortunately, osteoporosis often can be managed to reduce the risk of fracture. Ongoing treatment can also greatly increase the quality of life for those who have already suffered osteopathic fractures. In some cases surgery will also be necessary.
The multidisciplinary team of trauma and fracture experts at Northwell Health Orthopaedic Institute treats osteopathic fractures as well as a broad range of conditions that affect the bones.