Young people’s nightmare of low-violence fractures

  Like most people, as a young orthopedic surgeon, I believe that most low-violence fractures occur in older adults, especially older women. Examples include fractures of the distal radius and fractures of the proximal femur due to slippery road falls. The typical phenotypes of such fractures are insignificant fracture displacement (long spiral fracture in tubular cortical bone and splitting and compression in the epiphysis), less severe swelling, and mild soft tissue injury.  However, some recent cases have been reminding me that something seems to have changed. Some fractures of the distal radius, which mostly occur in the elderly, actually occur in young women. And they fit the typical characteristics of low-violence fractures in the elderly —- Fracture displacement is not significant, swelling is not severe, and soft tissue injury is mild. I am on duty for young falls resulting in wrist pain, usually after physical examination. If the swelling is not severe, the soft tissue damage is mild, and there is no deformity.  They will not be advised to do X-ray examination. However, a few recent patients, who strongly requested and had X-ray done, actually found a distal radius fracture with little displacement of the fracture, only the fracture line could be seen in the distal radius, the dorsal radius bone was compressed, and the radial palmar inclination angle became smaller. This injury can heal with a wrist brake for about one month. However, the patient just fell when she raised her leg and her arm was extended back to the ground. Later, I asked the patient, she sits behind the counter all day long. There was almost no outdoor exercise and no sunlight. I guess eating is also fast food fast food every day!  There is no difficulty in treating this kind of fracture. The hard part is what to do in the future. They are still very young (away from being considered elderly by the UN). In the future, if this trend does not change, the consequences are unthinkable. It is not just elderly senior orthopedic patients that are now challenging trauma orthopedics. Orthopedic surgeons are alarmed by the fact that fractures in older adults are occurring in young people who are “white (no sun exposure), quiet (no exercise), and soft”.  And many young women who have had children often come to the clinic. They always say they have pain in their back, legs and knees, and they are uncomfortable over and over again. We can only talk about calcium deficiency, please take calcium supplements. Calcium deficiency may be one of the reasons. But there must be a more important reason. The environment and food safety is not something that we ordinary people can change. But the sun and exercise is something that we all should make efforts and changes for our own responsibility, for our families, and for our society.  Whether young or old, for the sake of your bones and a better life. Please come outdoors, please exercise!  But do a long time “white, quiet, soft” young people, suddenly exercise gradually, do not overdo it. Cause sports injuries, the loss is not worth it. But the benefits of exercise and the sun for everyone is very large.