If I fracture a bone, will it change my treatment? Will a broken bone take longer to heal? Will a broken bone be repaired or casted differently?
To heal a broken bone can be challenging at any age, but if you have osteoporosis, you are more likely to be in your middle years or older. Healing does happen more slowly as we age. It is more important than ever that you have a healthy diet and get the proper nutrients for healing. Your diet should be a healthy one, including adequate but not excessive protein. You should also be especially careful to get the appropriate amounts of vitamins and minerals, particularly calcium and vitamins A, C, and D, all of which contribute to healthy bone development and healing whether you have a fracture or not. You should stay on your osteoporosis medication unless told otherwise by your clinician, but it's also a good idea to ask if there are any medications you should discontinue while you are healing.
Depending on which bone you break, the repair and treatment may be a little different:
Hip. Because you will be less mobile for a period of time (see Questions 77 and 78), it is important for you to stop certain medications that can put you at risk for blood clots, such as Evista (raloxifene) and MHT (estrogen or estrogen and progesterone). Casts are not applied to broken hips the way they are for other broken bones. Broken hips can take a very long time to heal, and complete healing may never take place. Many factors contribute to the healing process, not the least of which is the person's physical condition prior to the broken hip. The caretakers, who themselves may be quite a bit older, may not be able to provide the intensive care that is often needed for recovery. And the isolation associated with immobility can lead to severe depression, which has a huge impact on healing.
Wrist. Fracturing a bone in your forearm, usually near your wrist, does not cause the same problems of disability and even death that are attributed to hip fractures. However, wrist fractures can cause persistent pain, functional and nerve problems, bone deformities, and arthritis. Although a wrist fracture is less likely to cause problems with walking and being mobile, it can still restrict you from getting out of the house, especially if you need to drive. It can also prevent you from doing activities of daily living, such as bathing and meal preparation. You will likely have a cast applied to your forearm, which includes the area below the elbow down to the thumb and fingers. Typically, a simple fracture requires a cast for 4 to 6 weeks, but depending on your ability to heal, you may have a cast longer.
Vertebral fractures. Fractures of the spine can be painful or they can be "silent," meaning that they are present but not necessarily painful (see Question 83). These types of fractures cannot be put in a cast. However, some clinicians might still recommend that you wear a metal brace that prevents your spine from twisting or bending. There is controversy about whether a brace provides sufficient pain relief to warrant its use and whether the immobility provided by the brace causes more harm than good, so braces are recommended infrequently. Vertebral fractures can cause considerable disability and distress. In addition to staying on your currently prescribed medication, Miacalcin NS or Fortical may be added to ease some of the pain associated with your spine fractures, and it may work with your current medication to increase your bone density even further. This type of fracture can take many weeks to heal. Unfortunately, simply having one osteoporotic spinal fracture significantly increases your risk of having another within 1 year's time.
Although my ankle fracture occurred about 5 months ago, I think it's going to take me a full year to recover. I never would have guessed that this type of fracture could take so long to heal. I still have some pain and quite a lot of swelling, although I'm able to get around on my own. My orthopedist said that I should expect to have arthritis in the ankle and to go back to the elliptical machine instead of walking as my form of exercise. I have started taking estrogen again for my menopause symptoms, although I had stopped it during my recovery because I was fairly immobile.
When I first fractured my ankle, the surgeon came out with crutches, expecting me to use them. He obviously didn't know I was a klutz and would have broken the other ankle if I actually continued to use them. I constantly felt like I was going to fall. Crutches and walkers are the equivalent of walking on your hands! So, instead of seeing a wheelchair as a sign of failure, I saw it as my only option to get around. I went everywhere in it. That wheelchair allowed me to go back to work and to do almost everything I was used to doing before the accident. I used nothing but a wheelchair at home, too. I was home alone during the day for about a month, and I was petrified of falling while using crutches or a walker. The wheelchair was the single most important reason I was able to stay active and mobile. And it saved me both financially and socially because I was able to return to work probably about 6 weeks sooner than I would have had I stayed on crutches. I tell everyone that a wheelchair is not a sign of weakness or failure!
Recovering from a fracture like this has been an enlightening experience for me. I look for handrails and handicapped access everywhere I go now. I never realized how seriously breaking a bone could impact your life. I'm very conscious now of not putting myself in situations where I could fall. Although I was wearing low-heeled, rubber-soled shoes when I fell, I recommend wearing high-top sneakers and cowboy boots for their ankle support!