Roughly 21 percent of West Virginians are age 65 or older. According to a policy brief from WVU, West Virginia has the third-highest percentage of senior residents in the nation. The health of the state’s older residents is a top priority for WVU Medicine Wheeling Hospital. Their Orthopaedics department has dedicated specialists with expert training in fragility fractures, which disproportionately affect the senior population and can have devastating health outcomes if not prevented and treated properly.

“A fragility fracture is a bone break that typically occurs after a low-energy trauma, like a simple fall. The same degree of trauma would not typically cause a fracture in a younger patient with healthy bone given the same mechanism of injury,” explains Dr. Ivan Tarkin, orthopaedic trauma surgeon and trauma specialist at Wheeling Hospital.

Typically, fragility fractures occur secondary to osteoporosis, a common disease that weakens the bones and progressively worsens over time. Risk factors include advanced age, low body weight, and family history of the disease. It is more common in women due to post-menopausal estrogen loss. Women with osteoporosis lose up to 20 percent of their bone density within five to seven years after menopause. Certain medications and medical conditions can increase the risk of developing osteoporosis. Lifestyle factors such as physical inactivity, smoking, excessive alcohol consumption, and high caffeine intake also increase the risk.

There are measures you can take to lessen your risk of developing osteoporosis. Supplementation with calcium and vitamin D is recommended, as well as weight-bearing exercises that help strengthen bones. Good nutrition, including adequate protein intake helps keep bones and muscles strong. Smoking and alcohol consumption dramatically increase the risk of Osteoporosis.

According to Dr. Tarkin, many patients don’t realize they have osteoporosis until they experience a fragility fracture, which commonly occurs at the wrist, hip, ankle, or shoulder. Dr. Tarkin and the orthopedic team at WVU Medicine has made it their mission to educate the public about bone health and help prevent injuries before they happen.

“Diagnosing and treating osteoporosis prior to fracture should be a priority with routine health maintenance,” he says.

Seniors who sustain a fracture can face devastating health outcomes. Up to 50 percent of older adults who suffer a hip fracture never again regain their previous level of mobility, and 20 percent will die within a year due to complications related to the fracture, such as infections, blood clots, and pneumonia. After one fracture, the risk of a second fracture doubles. Loss of independence, mood changes such as depression and anxiety, and financial strains can result from a simple fall.

WVU Medicine uses DEXA scanning technology to diagnose osteoporosis. DEXA stands for dual-energy X-ray absorptiometry and is a quick and painless test to measure the strength of a patient’s bones. It is considered the gold standard for diagnosing osteoporosis. DEXA scanning is essential for measuring bone density and guiding a treatment strategy for minimizing the occurrence of fragility fractures.

Modern treatment modalities for fragility fractures require a multidisciplinary approach in order to promote the best outcomes. Fracture care may consist of setting and casting the bone or surgical repair using metal implants to stabilize the break. Rehabilitation, nutrition counseling, and lifestyle modifications are integral to post-treatment care.

“Our team consists of emergency room doctors, internists, trauma surgeons, bone surgeons, nutritionists, osteoporosis nurses, and rehabilitation staff,” says Dr. Tarkin.

WVU’s Wheeling Hospital is taking a proactive approach to bone health by participating in the American Orthopaedic Association’s Own the Bone program. The Own the Bone initiative offers resources and a centralized registry that help hospitals and medical practices recognize at-risk patients, assess their bone health, and coordinate appropriate post-fracture or orthopaedic-surgery care.

A primary goal of this program is to decrease the incidence of fracture in senior patients. This program promotes bone health by encouraging dietary modification (like calcium and vitamin D supplementation), recommending exercise programs, counseling on risk factors such as tobacco and alcohol use, as well as referral for DEXA scanning and medications that improve bone health.

“We are fortunate to have sustained the distinction of ‘Star Performer’, which demonstrates our dedication to this initiative and care for our senior population,” says Dr. Tarkin.

The Own the Bone initiative involves a fracture liaison service that identifies and follows fragility fracture patients. Wheeling Hospital’s dedicated liaison, Toni Nucci-Rinkes, RN, BSN, and Program Coordinator, meets with seniors after fragility fractures to provide guidance on evaluation and treatment.

“Toni provides our patients with both education and a plan for improving bone health. Further, she assists continuity of care in the outpatient setting for diagnosis and treatment of osteoporosis. She is an invaluable asset for fracture prevention in our senior population,” says Dr. Tarkin.

With a team of experts in trauma, joint replacements, sports medicine, foot and ankle and upper extremities, WVU Medicine is positioning itself as a destination for world-class orthopaedic care. Their partnership with Own the Bone is improving the health outlook for older adults in West Virginia and beyond.

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