Question

Mary-Lou’s family was happy with the management plan established by the doctor as Mary-Lou was progressing quite well. She was using notepads to jot down reminders, a pillbox to keep her medication organized and a calendar to record appointments. Her family members were helping her with routine tasks such as cooking and paying bills. She was feeling much happier and did not have to rely on alcohol to go to sleep. On one particular day she was feeling so good she decided to walk to her GP appointment alone. On her way there she stumbled over a branch and fell. She felt excruciating pain in her hip. A passer-by called an ambulance and she was taken to the emergency department at the Royal Melbourne hospital. An X-ray revealed that she had broken the neck of her femur and had to have surgery to repair it. Mary-Lou wondered whether this was linked to the crepitus she had been experiencing in her joints. Her joints did feel quite stiff and painful lately. The specialist explained to Mary-Lou that the crepitus was likely due to degeneration of her cartilage and said that the fracture might have been due to weakened bones. He told her he would like her to have a bone mineral density test to measure her bone density. The DEXA scan gave a T-score of -3.0. Mary-Lou is now given bisphosphonates and told to increase her daily intake of calcium.

Question 7 Discuss why Mary-Lou’s fracture may take longer to heal than it would for someone who was half her age. In your answer, you are expected to name and discuss three physiological factors that are needed for healing to take place and explain how each of the factors you identified is affected by ageing. Finally, name two complications of hip fracture that are prevalent in the elderly.

Answer 1

Ans 1-Mary Lou's fracture may time more time to heal since she had weakened bones . Since her T score was -3.0 she was suffering from osteoporosis since the normal T score is -1.0 or above for normal bone mineral density. T score of -2.5 or below indicates osteoporosis.

Ans 2-Three physiological factors which are needed for healing to take place are-

(A) Nutrition- Better nutrition makes healing faster to take place. While with increasing age nutrition of most people is found to be decreased.

(B) - Oxygenation - proper oxygenation of the body makes healing faster. With increasing age oxygenation of body do not go much better .

(C) Diseases- Diseases in the body decreases the rate of healing. Since with increasing age chances of various diseases increases so process healing slows down.

Ans 3-Two complications of hip fracture in elderly can be-

- Bed sores.

- Urinary tract infection