Determining The Type Of Fracture A Person Has Sustained Can Reveal If Nursing Home Abuse Is Responsible
As we age, our bones become weaker and are more susceptible to dangerous bone breaks. This is because older bones form small cracks more easily, which makes bone breaks more likely.
In order to prevent dangerous bone breaks-- and to help determine fractures that may be the result from situations involving nursing home abuse-- it is helpful to understand the types of fractures and what causes them. Common types of bone fractures include:
- Stress fracture
- Spontaneous fracture
- Compression fracture
- Traumatic fracture
Stress Fracture
Stress fractures are actually tiny cracks in bones caused by overuse and repetitive motion. They occur mostly commonly in the lower-legs and feet because these are weight-bearing bones. Stress fractures may be barely noticeable at first, but the swelling and pain will intensity as they worsen. Therefore, it is important to receive proper care and treatment to prevent the stress fracture from becoming more serious.
As with most bone breaks, osteoporosis or weak bones increases your chance of suffering from painful stress fractures. And, to further complicate matters, a study indicated that some post-menopausal women who take biophosphonate drugs such as Actonel, Boniva, Fosomax, and Reclast might actually have a higher risk for hip fractures. (See “Study Links Commonly Prescribed Osteoporosis Drugs To An Increase in Hip Fractures”) It is important to discuss any new medications with your doctor, who will help you weigh the benefits and risks of drug treatment.
In a nursing home setting, staff members should be aware of the signs of stress fractures, so a resident’s care plan can be altered to prevent further damage and alleviate pain. Signs and symptoms are swelling and pain, especially in the lower legs and feet. Nursing home staff or doctors use x-rays to diagnose stress fractures.
Early treatment of stress fractures is important, so the cracks do not worsen. Treatment includes reduced activity until the bone has a chance to heal. However, some stress fractures are harder to heal and are prone to re-injury. Therefore, it is important that nursing home staff monitor the resident’s injury to ensure that proper healing occurs.
Spontaneous Fracture
Spontaneous fractures (also known as compression fractures) are bone breaks that occur without trauma in what seem like normal bones. The spine and hips (bones that directly support your weight) are the bones most likely to be affected by spontaneous fractures. Older bones are more vulnerable to compression fractures because they lack the internal support structures to withstand impacts and pressure. Osteoporosis (weak and brittle bones) is the most common cause of spontaneous fracture.
A 10% bone mass loss in the vertebrae can double the risk of vertebral fractures and a 10% loss of bone mass can increase your risk of hip fracture (2.5 times greater chance of hip fracture). Hip fractures are one of the most common injuries for elderly people. They usually occur because of a fall and can cause serious and even life-threatening medical complications.
While walking exercises are often valuable tools to help maintain health (bone health) and promote strength, strenuous walking exercises can contribute to spontaneous hip fractures. Therefore, it is important to personalize individual walking plans for elderly residents according to their bone health, which can be determined by BMD (bone mineral density) tests.
Hip fractures usually require surgery to realign the bones, often with surgical screws, metal rods, or plates. Then, after surgery the main focus is on controlling pain and preventing infection. The best thing to do after hip surgery is to start moving around as soon as possible. This helps reduce recovery time and prevent dangerous complications such as blood clots, lung congestion, and pressure sores.
Oftentimes, a walking aid (walker, crutches, or cane) is used in the months following surgery. Physical therapy will help the resident regain their strength and independence. However, many elderly nursing home residents are never as independent as they were before their hip fracture. And, if the resident makes no improvements, physical therapy is often cut short.
Elderly persons can also suffer from compression fractures in their spine, which occur when the vertebrae (back bones) become so weak that they compress or collapse. Again, osteoporosis is the main cause of vertebral compression fractures. A compression fracture of the spine can cause severe pain and a stooped posture or even a hunchback (kyphosis). While this type of compression fracture will often heal on its own after 8-12 weeks, previous spinal compression fractures increase your chance of suffering from additional compression fractures of the spine.
Trauma Fracture
Elderly people are susceptible to dangerous falls because of poor balance and coordination, weakness, changes in gait, poor vision, illness, medications that cause sleepiness or dizziness. Over 11 million people over the age of 65 suffer dangerous falls every year. That is an astonishing one out of every three senior citizens.
Your wrists and hips are the bones most likely to break if you suffer from a fall. Your wrists are susceptible to breaks from bracing yourself with your hands as you fall. And, your hips are more susceptible to breaks because as you age your bones (especially your hips) are less able to withstand impacts, and your hips often receive the brunt of the impact when you fall.
After an accident or fall, nursing home staff members will examine the injured area to look for bone breaks, cuts, bruising, or other signs of injury. The staff will ask questions and investigate how the injury occurred. This investigation into the cause of the fall is very important to protect the resident and prevent future falls.
If the resident lost consciousness, this could be a sign of a more serious condition, such as a stroke or heart attack. In the case of a possible bone break, the resident will be treated by a physician who will determine whether x-rays are necessary. The doctor will use a splint or case to immobilize bone breaks that occur on the arms, legs, hands, and feet. However, as discussed above, hip fractures usually require surgery and post-operative physical therapy to help improve mobility.
Understanding the significance of each type of fracture
Understanding the different types of bone fractures can help prevent dangerous bone breaks by avoiding dangerous situations and taking preventative measures. Nursing home facilities are required to keep the facility free from accident hazards and take preventive measures to prevent dangerous falls.
Each resident should have an individual care plan specifically tailored to their strengths and weaknesses in order to provide the best care possible. If you or a loved one suffered a dangerous bone break while a resident at a nursing home facility, you may be entitled to compensation.
Sources:
Amherst Bulletin: When Seniors Fall, Perilous but Preventable
e-Medicine: Lumbar Compression Fracture
WebMD: Understanding Fractures
Pub Med: Spontaneous fracture – multiple causes
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Bone health is a serious concern for older adults. As you age, your bones get weaker as they lose their internal support structures. Older, .png)
I have a lot of clients who almost apologically tell me how their loved ones 'brittle bones' are responsible for the extensive nature of their injury . Sure, their bones may be weakened and brittle, but that is not a defense to a claim against a nursing home or hospital for providing inadequate care..png)
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Given the frequency (approximately 80+% of all nursing nursing home patients will experience a fall this coming year) with which nursing home falls occur, facilities must be on the lookout when it comes to implementing fall prevention techniques in order to improve patient safety. Too often, the prevention comes too late-- if at all..png)
Elmwood Care
Like many families, Kenneth Gall sought a sense of closure with respect the circumstances surrounding his mother's death after she sustained an injury during her admission to Presbyterian Homes of Arden Hills. Unfortunately, more than a year after his mother's death, questions still remain as to the facilities role in the matter-- and how a disabled, primarily bed-bound-woman managed to fracture her neck while admitted to a nursing home..png)
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There's no doubt about it, falls in the elderly population are a major cause of injury and even death. The New York Times, ran an .jpg)
Many elderly people suffer broken bones during admissions to nursing homes due to; falls, being dropped, or perhaps improper care from staff. Regardless how the fracture occurred, a fractured bone in the elderly must be timely identified and treated..png)
The California Department of Health has issued a "AA" citation and a $90,000 fine to 
A report issued by the Minnesota Department of Heath has cited White Community Hospital and Nursing Home for errors made by a nursing assistant during the transfer of a patient. The incident occurred when the CNA attempted to transfer a disabled patient from their bed to a wheelchair using a sling. During the transfer, the patient was dropped. The patient suffered a broken arm and leg which contributed to their death two days later.
Frequently undiagnosed and under-appreciated, falls amongst the elderly can frequently result in brain bleeds or technically termed 'subdural hamatoas'. Because elderly are predisposed to developing subdural hamatomas, staff in nursing homes and hospitals need to be tuned into the symptoms and when to seek additional medical care.
I've noticed a trend amongst many nursing home negligence cases-- injuries occur at a disproportionately high rate within the initial admission period. The most reasonable explanation for the heightened rate of injuries in during the initial admission period is most likely related with both the facilities unfamiliarity with the patient and vice versa. .png)
Along the lines of injuries shortly after an admission, on June 13, 2009, a resident fell out of bed and later died at .png)
On June 13, 2009, a nursing home patient fell out of bed and died at 
Hypotension.png)
Two falls within a 24-hour period resulted in the death of a California nursing home patient. The incident involved a patient was was recently admitted to the facility for rehabilitation following hip surgery. The falls took place on May 9th and 10th at Aviara Healthcare Center in Encinitas, CA. 
The family of a Chicago nursing home resident has filed a wrongful death lawsuit against Sacred Heart Nursing Home in connection to a fall at the facility. The lawsuit asserts that Sacred Heart failed to supervise the nursing home patient with bipolar disorder, schizophrenia and a propensity to fall..png)
A nursing home negligence lawsuit has been filed against Stearns Nursing and Rehabilitation Center after a 95-year-old resident fell on multiple occasions and suffered hip fractures. The lawsuit alleges that the facility failed to implement fall precautions despite the fact the facility knew the resident suffered from Alzheimer's, was generally confused and considered to be a 'high fall risk'.
While in the fall mode, I came across this 
or residents who may be easily agitated (due to uncontrolled pain). The most commonly used restraints used in the nursing home setting are bed rails and geri-chairs. However, nursing homes have been be known to use make-shift 'tie downs' thereby securing residents to beds, benches, dining chairs and even toilets.
Investigators interviewed both Gall's family as well as staff at Alden Hills in attempting to determine the cause of Gall's broken neck. Additionally, a neurosurgeon was consulted for the state's investigation and verified Gall suffered a hangman's fracture. Further, the neurosurgeon opined the severity of the hangman's fracture could not have occurred without trauma. Although no specific traumatic event could be identified as the culprit of the injury, three conclusions were reached in the report:
. Menneke fell several times over the course of her admission, suffering a traumatic brain injury and fractured bones. 
What makes these unnecessary events so disturbing is that they occurred within days of each other--these are not isolated incidents. The events have prompted inspections by state nursing home inspectors. Pennsylvania Health Department, director of nursing-care facilities Bill Bodner, sums the situation up well, 'the crux of our concern is the fact that in each case, there was miscommunication between the physician and nursing staff, and no clear plan of how the staff should treat these patients.'
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