Besides General Orthopaedic Services, we provide Subspecialty Services based on training, experience and clinical interest. The paradigm shift in managing orthopaedic conditions has resulted in sub-specialization to provide a more comprehensive and clinically relevant management to the specifics of the condition of concern. It is holistic yet patient and condition specific to ensure appropriate and timely treatment for a specific condition.
Orthogeriatrics
Overview
Orthogeriatrics or Geriatric Orthopaedics is the management of orthopaedic problems in the elderly (above the age of 60). As the aging population in on the rise worldwide with a significant recent increase in Asia, a specialised care for orthopaedic concerns in these individuals is very crucial. Traumatic injuries and Joint Related Issues can occur ‘through the ages’ in a variety of pattern and degree of severity. However, there are greater tendencies for high velocity traumatic injuries in the younger individuals resulting in complex fractures and sports related injuries. On the contrary, trivial injuries in the elderly, can results in complex fractures due to poor bone quality (brittle bones).
Clinical Implications
Fragility fractures in the elderly population is on the rise with the most common being hip fractures. With osteoporosis and pre-existing comorbidities, an elderly folk with a trivial injury or fall is highly susceptible to a fragility fracture. In view of significant osteoporosis, fractures involving brittle bones require special fixation implants and techniques. In certain circumstances when the fracture (brittle bone) is involving a joint, fixation may not be ideal and a Joint Replacement is performed to restore function.
Treatment Options
Management in the elderly goes beyond fracture fixation or joint replacement surgery. Of paramount importance is to treat the injury ‘timely’ to prevent secondary complication of recumbence like bed sores, urinary tract infection and chest infection. Geriatric orthopaedic patients often require an integrated approach to manage the osteoporosis and other medical issues. The management would often require co-management with a Geriatrician and other relates Specialist. Rehabilitation is of great importance especially in the elderly to restore mobility and activities of daily living after an injury. This requires appropriate and regular physiotherapy with long term follow up.
Integrated Approach
The delivery of integrated and holistic care for the aging population is particularly important. This is a specialised service to address multiple concern besides the orthopaedic issue. When delivered timely and appropriately, it can make a difference in the functional outcomes.
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