Fracture in the Elderly

by Dr. Tan Boon Cheong

MBBS (MU),. MS Ortho (MU)

Not too long ago, I remember writing an article regarding osteoporosis for this column. Thus, I find it appropriate to bring up the topic regarding fragility fractures in the elderly. A fragility fracture is defined as a fracture that takes place due to a fall from a standing height or less.

Domestic falls in the elderly happen rather frequently when they get out of bed in the middle of the night to go to the toilet. Several reasons could have attributed to the fall, for example, giddiness, poor lighting, poor balance or a slippery floor. Fragility fractures are most common in three places, namely the wrist, spine and hip.

A wrist fracture is a common fracture seen in an osteoporotic bone. This fracture occurs more commonly in women compared to men with a ratio of 10:1 at the age of 70. This fracture usually occurs due to a fall on an outstretched hand (trying to stop a forward fall). Most of the time this fracture can be managed with casting, but occasionally surgical fixation might be necessary. 

In the spine, a vertebral body compression fracture can take place with an individual landing in a sitting position after a slip. In some patients, this fracture might even occur when driving at high speed across a road bump. The main symptom of a compression fracture is severe back pain. You will be surprised that some patients might not even know that they have a compression fracture, as they present with mild symptoms and it is only picked up during some other routine check-up. Majority of patients with this compression fracture are treated conservatively with medication, rest and physiotherapy. Some patients will choose to undergo procedures such as percutaneous vertebroplasty (injecting bone cement into the vertebral body) or kyphoplasty (jacking up the compression segment) for pain management. It is rare for the need of an open surgery unless there are obvious neurological deficits that require decompression of the spinal cord. 

Lastly, is the hip fracture. This is a fracture that will compromise the quality of life and shorten the life expectancy of a person. It has been shown that older patients have five to eight times higher risk of dying within the first three months of a hip fracture compared to those without a hip fracture. The two most common places at the hip which are most susceptible to fractures are the intertrochanteric (extra-capsular) and neck of femur (intra-capsular). Almost all hip fractures require surgical intervention. Without surgery, complications such as pressure ulcers or orthostatic pneumonia might occur.

A fragility fracture is something that is important to prevent and treat irrespective of where the fracture occurs. This fracture can bring about depression, loss of function, loss of mobility, loss of independence and loss of quality of life. Thus, screening and treatment for osteoporosis should be emphasized on. It is essential to make sure one has healthy and strong bones and not regret only after a fracture has taken place. 

Luxury Is Great Britain 奢华英伦

Britain has developed a taste for luxury over the centuries and perfected the art of showcasing its elegant side to her visitors. Enjoy fashionable restaurants, shopping and culture, and hire historical castles and islands to stay and play at. Get a taste for the life lived by royalties. For your shopping spree, seek out the royal crest above shop doors to unlock the highest quality products favoured by none other than the Queen of England.

The Attraction

The Shard

The best view of London can be seen from The Shard’s 72nd floor — The View from The Shard with unparalleled 360-degree view for up to 40 miles. The 95-storey skyscraper in Southwark is London’s new emblem. Besides its extraordinary and exquisite architectural design, The Shard houses many occupiers including the famous Shangri-la Hotel as well as retailers, restaurants, offices, education institution, medical and more.

Opened in July 2012, The Shard’s designer Renzo Piano was inspired by the spires of London churches and the tall ships depicted by Venetian painter Canaletto. Visit The Shard website for more architectural designs that include eight sloping glass facades’, the ‘shards’, the architectural shape and visual quality of the tower, the unique glass/design to reflect the lights in unpredictable ways and more.

The Shard is utterly impressive and certainly a vision of inspirations. Catch London’s iconic sights of the London Bridge, Tower Bridge, River Thames, The London Eye, The Cheesegrater, The Gherkin and many more from this amazing skyscraper.

Blenheim Palace

A World Heritage Site as designated by United Nations, Blenheim Palace was the gift by Queen Anne and a grateful nation to the first Duke of Marlborough, John Churchill and his wife, Sarah Churchill, for his great victory at the Battle of Blenheim in 1704. It is also the only non-royal non-episcopal country house in England to hold the title of a ‘palace’.

Worthy of a visit for its famed history and architecture, Blenheim Palace’s architecture was built in the English Baroque style by architect John Vanbrugh. Enrol for their Lights, Camera and Action tour and be enthralled by the amazing mass ornamentation through the rooms of The Great Hall, The Green and Red Drawing Rooms, The Saloon, The State Rooms, The Long Library and more. Baroque grandeur and bold colours trapezed throughout the palace, leaving one in awe of its majestic appearance.

Perhaps a reminiscent of a James Bond film Spectre may further entice one to visit Blenheim Palace if its history did not lure one’s attention. Filmed at its courtyard, the car chase scene in Spectre did ultimately boost Blenheim Palace to higher fame. There were certainly many more famous movies that were also filmed at this palace.

Expect to spend at least half a day here unless you’re a history junkie who pauses at every glorious space of the palace, then one may well take up a full day at Blenheim Palace.

The Accommodation

Luxury really does mean luxury in Britain. Experience true traditional British opulence at classic, luxury boutiques or even private and exclusive accommodations from suites, castles to modern hotels.

Nobu Shoreditch

Nobu Shoreditch is a relatively newcomer to the Shoreditch scene, opened last year, is the first Nobu hotel in London. Contemporary and elegant, its style is inspired by Japanese architecture and décor as well as east London industrial styles. As with all Nobu properties, the design reflects the city of origin, combined with the brand’s signature east-meets-west philosophy. Head to its fantastically cavernous restaurant for Japanese delicacies such as the oven-roasted lobster with Hakaido scallops or the exclusive cilantro aioli and Ikura.

Eagle Brae

Eagle Brae is a luxurious log cabin village in the heart of the Scottish Highlands. Hidden away on a remote highland hillside, amongst magnificent glens and towering Munros, Eagle Brae combines breath-taking scenery and untamed wilderness of the Scottish Highlands with uber-luxe accommodation and all the comforts of home. Far removed from the rest of the world, their enchanting, dog-friendly log cabins, spectacular views and abundance of wildlife are just some of the reason why this is a unique highland hideaway, unlike anything you have ever experienced before.








身为联合国教科文组织世界遗产遗址的布伦海姆宫,是安妮女王当年为了表彰和嘉奖马尔伯勒公爵一世赢得 1704 年 “布伦海姆之战”后而赐予,这也是英格兰唯一以非皇室宫殿。


到这里取景的电影及电视无数,但令人印象深刻的是占士邦电影把布伦海姆宫当作罗马的 Palazzo Cadenza 宫的拍摄地点,在此上演一幕逃命追杀,也让布伦海姆宫因此吸引不少邦粉前来朝圣。






Eagle Brae 苏格兰小屋

Eagle brae 是设在苏格兰山区的奢华小屋,适合一家人入住,而且这山区风景秀丽,小屋彷如自家屋里的温暖及舒适。远离繁嚣城中之馀,又可带狗同住的世外桃园。

The Snake through Art, Jewellery & Design 贯穿艺术、 珠宝与设计之蛇

Following the success of previous editions, BVLGARI will inaugurate the fourth edition of SerpentiForm at the word renowned Chengdu Museum. It will be available to public from the 29th April to the 25th of August. 

Epitomising seduction, rebirth and transformation, the snake as a symbol has been intertwined for centuries with the story of mankind, capturing imaginations from East to West. During the 1940s, BVLGARI captured the expressive power of this evocative symbol, reinterpreting it for the first time in jewellery with supple bracelet-watches.

Precious antiquities from Italy and from China examine the different symbolic meanings of the snake, ranging from objects of veneration to talismans, from a form of generative divinity to a medium to communicate with otherworldly dimensions. The exhibition also features costumes from prestigious theatre and fashion archives, such as an amazing Turandot costume of 1926 on loan from the Giacomo Puccini Foundation in Italy. Moreover, delightful vintage evening dresses will illustrate how the snake became an eccentric ally for women in their playful seduction.

Lastly, a review of splendid BVLGARI Serpenti creations from the Maison archives and private collections will close the exhibition. The selection includes current creations and archival creations that will be on display for the very first time. 



展会的看点还来自著名剧院和时尚珍藏馆的服饰,比如1926年从意大利普契尼基金会(Giacomo Puccini Foundation)借来的一件令人惊叹的图兰朵之服装。此外,透过怡人的复古晚礼服将叙述蛇如何成为女性们的古怪盟友,进行俏皮的诱惑。


Image(s) courtesy of Bulgari