What is Geriatric Orthopaedics?
Geriatric orthopaedics is a sub speciality of orthopaedics dealing with treatment of orthopaedic problems and injuries in the old age.
How is Geriatric Orthopaedics different?
Geriatric orthopaedics is different from general orthopaedics in many ways. Firstly, the problems of old people are different from those of younger patients. Secondly, the quality / strength of bones in old age is weakened by osteoporosis leading to fracture on trivial trauma, also due to the poor bone quality, treatment of a severe fracture occurring in young age is totally different from the one occurring in old age. Thirdly, human body in old age is affected by a number of medical ailments like cardiac disease, hypertension, respiratory disease, diabetes, electrolyte disturbances, etc.[ SO THE MANAGEMNET OF PATIENT AS A WHOLE REQUIRES A TEAM AWARE OF, AND SKILLED IN MANAGING THESE ISSUES ALONG WITH THE ORTHOPAEDICS AILMENT.]
Why a totally separate department?
Applying the principles of orthopaedics to a geriatric patient requires the highest medical skills, the best surgical techniques and, a team aware of and trained in dealing with these issues. Such an understanding and having a well planned aggressive attack on the orthopaedic ailments of the elderly is well rewarded by the results.
Understanding Geriatric Orthopaedics
The most important sign in Geriatric Orthopaedics is the ability to walk. Unable to walk, the patient has lost independence. The old person wishes to live with an acceptable quality of life. The end result of treatment is restoration of the patient to a satisfactory level of independence so that life continues to give satisfaction. In order to achieve this it is important to understand certain principles of geriatric arrangement.
Two conditions particularly working against a full return to independence in the elderly are bed rest and a long stay in hospital. This is not so important in the healthy middle aged patient, but most old people suffer from a greater or lesser degree of ill health with the orthopaedic condition . Invariably the geriatric patient admitted to hospital in an emergency not only has anaemia, but also one or more other diseases that will have an important bearing on the outcome of the orthopaedic procedure and subsequent rehabilitation and these are often exacerbated by inactivity. Inactivity causes not only rapid loss of strength and muscle tone but also increases osteoporosis and activity must be maintained to prevent this loss. Apart from any other form of injury, elderly people are liable to stress fractures because of osteoporosis and the risk is enhanced after a long stay in bed.
Secondly, decubitus can leave other adverse effects particularly on the respiratory and urological systems. It is a cardinal principle in the practice of geriatrics that a patient with pneumonia is better treated out of bed. This is most important and must be applied to orthopaedics in the elderly because it indicates that the chosen operative procedure must allow the patient to be moved out of bed immediately afterwards.
Once up and walking, the patient returns home soon. The patient finally thanks the decision of taking a reasonable chance to achieve a happy independent and good quality of life by having an operation than to linger on in pain, unhappiness and dependency..
Geriatric Orthopaedics is not only osteoporosis & osteoarthritis!
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