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• Exercise Programs: Strength and balance training (e.g., Tai Chi, physical therapy).
• Medication Review: Adjusting prescriptions that increase fall risk.

3. Orthopaedic Management of Falls

Common fractures due to falls include hip fractures, wrist fractures (Colles’ fracture), and
vertebral compression fractures.

• Hip Fractures: Often require surgical intervention (hip pinning, hemiarthroplasty, or total hip
replacement).
• Wrist Fractures: Managed with casting or open reduction and internal fixation (ORIF).
• Vertebral Compression Fractures: Treated with bracing, pain management, and in some cases,
kyphoplasty.

Osteoporosis and Fragility Fractures

1. Pathophysiology of Osteoporosis

Osteoporosis is characterized by low bone mass and structural deterioration, increasing
fracture risk.

• Primary Osteoporosis: Age-related bone loss due to hormonal changes.
• Secondary Osteoporosis: Caused by underlying conditions such as hyperthyroidism,
corticosteroid use, or malnutrition.

2. Diagnosis and Screening

• Dual-energy X-ray Absorptiometry (DEXA Scan) measures bone mineral density (BMD).
• T-score Interpretation:
o Normal: >-1.0
o Osteopenia: -1.0 to -2.5
o Osteoporosis: <-2.5

3. Treatment Strategies

• Calcium and Vitamin D Supplementation
• Bisphosphonates (Alendronate, Risedronate)
• Hormone Replacement Therapy (HRT) in Select Patients
• Weight-Bearing Exercise to Promote Bone Strength