Surgery for Osteoporosis

Serious hip, spine, and wrist fractures often require surgery

If you have a serious osteoporosis fracture, you'll most likely need surgery. The most common locations for osteoporosis-related fractures are in the hip, spine, and wrist.

Though osteoporosis can affect any bone, this article will focus on surgical techniques used on fractures in the most common osteoporosis-affected sites.

Surgery for Hip Fractures
A hip fracture is a serious injury that often requires surgery and takes months—even a year—to recover.

The majority of hip fractures occur in people who are 65 or older. Falls are the top cause of hip fractures, which often happen where the femur (thighbone) meets the hip joint.

If you fracture your hip, you'll probably need surgery. The type of surgery, however, depends on the severity and location of your particular hip fracture. There are two main types of hip fractures—femoral neck fractures and intertrochanteric region fractures.

Femoral Neck Fractures
These fractures occur where your femur fits into your hip joint. To understand this fracture, you need to understand the anatomy of the femur.

Think of the femur in terms of the human body. The femur head looks like a ball and fits into your hip bone, so it essentially connects the femur to the hip. The femur neck connects the femur head with the rest of the femoral body. If you have a femoral neck fracture, the femur head may be disconnected from the rest of the femoral body.

Below are surgical techniques for femoral neck fractures. Depending on the seriousness of your femoral neck fracture, you may need:

  • Metal screws: Also called internal fixation, your surgeon may implant metal screws to stabilize the bone while the fracture heals.
  • Hemiarthroplasty: Your surgeon may opt to remove the femoral head and neck and replace them with metal instrumentation.
  • Hip replacement: Your surgeon may implant a prosthesis after removing the upper part of your femur and pelvic bone socket.

Intertrochanteric Region Fractures
Like femoral neck fractures, intertrochanteric region fractures occur in the upper part of the femur. However, they don't affect the same parts of the bone. These fractures are simpler to repair than femoral neck fractures. Your surgeon will likely implant a metal screw across the fracture to keep the bone stable.

While surgery for hip fractures has a high success rate, you should expect a long recovery period. Also, a full recovery is not always a guarantee. There is a possibility that you may never move in the exact same way you were able to before your hip fracture.

Surgery for Spinal Fractures
Spinal fractures (also called spinal compression fractures) that are caused by osteoporosis often require surgery. The most common surgical techniques are vertebroplasty and kyphoplasty. Both are minimally invasive procedures that use thin tubes to inject orthopaedic bone cement into the affected vertebrae (back bones).

In vertebroplasty, your surgeon will inject the bone cement directly into the weakened vertebrae via a thin tube. The cement dries very quickly to secure the fracture.

In kyphoplasty (also known as balloon kyphoplasty), a tube is inserted into the vertebra. But unlike vertebroplasty, the tube is connected to a small balloon that creates space when inflated. It is then filled with the orthopaedic bone cement. The extra space restores vertebral height, which is often lost if you've experienced a spinal fracture.

To learn more, read a SpineUniverse article about surgery for osteoporosis spinal compression fractures.

Surgery for Wrist Fractures
Wrist fractures are common—in fact, they are the most common fracture site for women under the age of 75.

Your wrist has two bones—the radius and ulna—in addition to the small bones in your hand. If you fractured your wrist, it most likely occurred from the force and impact of using your hand to break a fall.

If you have a simple fracture, a cast or splint will sufficiently heal the broken bone. However, if you've experienced a more complex fracture—where multiple bones have been broken or the cartilage of the wrist joint has been affected—you'll most likely require surgery to reposition and fix the broken bones in place.

To do this, your surgeon might immobilize the fracture with pins to hold the bone fragments in place. Your surgeon can also use other instrumentation, such as plates and screws, to fix the position of the fracture.

Another method involves a device called an external fixator, which involves inserting pins into the skin and an external device (that is, it is outside of your skin) that pulls the bone into the correct position.

A wrist fracture can directly impact your daily activities, especially if you are older or if the fracture is in your dominant arm. Physical therapy will help return movement to your arm, but expect to take time to recover.

There are many safe, effective surgical methods for repairing your osteoporosis-related fracture. You and your doctor will discuss what options will best help relieve your pain.