On Saturday, October 30, Health Live @ Seniors Today hosted renowned Orthopaedic and Joint Replacement Surgeon, Dr Rajesh Dharia. He shed light on a serious and oftentimes fatal fracture afflicting seniors namely, fracture of neck of femur.
Dr Dharia is a leading Consultant Orthopaedic and Joint Replacement Surgeon based in Mumbai, having performed over 4000 replacement surgeries. Dr Dharia is trained in Mumbai, UK, Germany, the US, Japan and Australia. He operates at Saifee, Breach Candy, HN Reliance and the Cumballa Hill Hospitals amongst others.
Some facts about the femur bone:
- It is the longest and strongest bone in our body
- It bears a huge weight – of our entire upper torso
- The neck of the femur is particularly vulnerable to break, if your bone health is poor, as it is a tiny cantilever that joins the femur to the hip bone
- The neck of the femur fracture occurs in a larger proportion to seniors with multiple comorbidities; (diabetes, poor heart health, obesity, kidney disease, parathyroid issues etc)
Dr Dharia’s approach to neck of the femur surgeries amidst the current covid-19 scenario:
- All Covid-19 protocols are strictly observed
- Patients are require to do an antigen test before surgery
- Even in the case of an urgent surgery, all Covid-19 protocols are followed
- If the patient tests positive, then he/she is assigned a separate area with Covid specific protocols
Key concerns with regards to neck of the femur surgeries include:
- Immediate surgery is of utmost priority or else other complications set in quickly
- Fat embolisms and DVT (Deep Vein Thrombosis) are additional detriments to the surgical procedure as they can give rise to complications
- Obesity and other multiple comorbidities ( High BP, thyroid, diabetes , kidney disease and so forth),exacerbated by old age increase risks of being ambulatory exponentially
- Fixation or Replacement of the neck of the femur also impacts recovery.
- Fixation – the patient does take a longer time to get back to normal mobility
- Replacement – the patient’s ambulatory functions are restored more quickly
Osteoporosis and old age is yet another key concern
Osteoporosis and old age is a key concern – the trabecular network which supports the femur becomes sparse and its relationship with hip fragility and fractures is higher
A bone densitometry test will determine your AT and Z -scores. In other words if the AT and Z -score is under value, your risk of fractures is more probable.
Taking the correct medication (Vitamin D3, Calcium, Phosphates) regularly, is critical for care of the trabecular network which supports the femur bone.
One of the significant fallouts of the pandemic is that seniors who need more Vitamin D from sunlight, have fallen short of their levels as their outside movements during sunlight hours have been restricted. This has resulted in weaker bone health due to insufficient Vitamin D levels.
Some Key Professional advice from Dr Dharia:
It is said, “We enter the world from the pelvis and we exit the world through the neck of the femur.”
Prevention is better than cure, so support yourself if you require it. Some ways to ensure support include:
1) Use of a sturdy tripod to steady your balance
2) Keep bathroom and all floor surfaces dry, to prevent accidents
3) Maintain optimum bone health – by way of supplements, diet and exercise
4) Avoid activity that impacts the bones to safeguard against damage
5) High risk factors include; excess alcohol, high lipid profile, professions or activity like climbers and horse riders. These negatively impact the body resulting in less circulation to the femur and its consequences.
Dr Dharia’s high success rate in this specialised surgery is also enhanced by the fact that he has operated on his own father at 90+ and a couple of centenarians, with no problems and excellent recovery.
Today with highly advanced technology and breakthroughs in the field of specialty and OT surgeries, patients get all the necessary external support to heal and recover totally.
It goes without saying that an experienced surgeon will adopt a multi- specialty approach (taking into account all health parameters that need care). This quick and proactive response makes a huge difference to the entire process.
If you are a highly active and mobile person, you can go back to the same level of mobility with no problem, as long as you follow due and timely process.
Weight training and carrying weights do help strengthen the bones.
The moment you or a family member has identified that there could be a break in the bone, get the surgery schedule ASAP. No matter your age. Timely medical and surgical intervention will invaluably aid the entire procedure.
Time taken to recover from a neck of femur surgery:
This depends on a multitude of variables like we have discussed above. Each case is individual and with it the accompanying factors also play a pivotal role.
The quicker the surgery after the break the better all other parameters are maintained and the sooner you will be back in your room to recover. This is the main aim of the surgeon so as to prevent ICU admission and complications.
Recovery can take within a week or stretch into a month or more. The patient’s response and co-operation has a direct impact on full recovery and total healing from the process.
Ways you can prevent a fracture:
- Get an annual or bi-annual bone densitometry test. For various reasons, the DEXA scan is considered the “gold standard” or most accurate test. This full spectrum test gives you a detailed account of the health of all your bones. This holds special importance to menopausal and post-menopausal women, and seniors who are 60 + in general. A test from an established diagnostic center will give you an accurate analysis of your AT and Z -score.
- One can also do a smaller test like the heel bone test which will give you a presumptive account about your bone health.
- Constant malaise and body ache should not be ignored as this may be an indicator of high level of osteoporosis, which can lead to increased risk of fractures. So be alert and do take care of your bone health.
- Take precautions seriously as well as your supplements regularly to maintain good bone health especially if your AT and Z -scores are low, osteoporotic medication is a must.
Cost of the surgery:
Unfortunately there is no definitive figure. Costs will vary as per the cost of the bed or room, the hospital, surgery and ICU (if applicable) costs and a host of other complex variables.
Cost of the implant is Rs 50,000/ – 60,000/
Final takeaway was in the form of following all Covid-19 protocols; as even the double vaccinated people can fall prey to the Delta variant. So do keep the mask up and follow social distance norms, hand washing and all other protocols to stay safe, well and healthy.
Dr Dharia can be contacted through the following ways:
Log on to his website: www.boneandjointsurgeon.com
Email: rajeshpd51@hotmail.com
Clinic number: 9769200753
Happy Diwali to you and your loved ones! And do note that we will not be hosting our webinar next week. We look forward to you joining us next on Saturday November 13.
