How to manage fractures conservatively in an 80-year-old elderly patient

Generally, fractures in 80-year-old elderly individuals may be caused by decreased reaction ability, reduced balance, diminished muscle strength and muscle atrophy, osteoporosis, hyperthyroidism, among other factors. Conservative treatments such as manual reduction and immobilization, bed rest with limb elevation, dietary adjustment, functional exercises, and traditional Chinese medicine therapy can be adopted under a doctor's guidance. The details are as follows:

I. Causes

1. Decreased Reaction Ability

With advancing age, older adults experience gradually slower reaction times and reduced capacity to respond to sudden events, increasing the risk of falls and subsequent fractures in emergencies. It is recommended that seniors engage in moderate mental activities such as reading, playing chess, or puzzle games to maintain brain activity and improve reaction speed.

2. Reduced Balance Ability

The nervous system function in the elderly gradually declines, including vestibular function, vision, and proprioception. These changes impair balance, making it easier to lose stability during walking or turning, leading to falls and fractures. Regular balance training—such as single-leg standing or standing with eyes closed—can help enhance balance.

3. Muscle Weakness and Atrophy

As people age, muscle strength and volume naturally decrease, increasing the likelihood of falls during daily activities and thereby raising fracture risk. Seniors should be encouraged to perform moderate strength-building exercises such as walking, tai chi, or simple calisthenics to improve muscle strength and mass.

4. Osteoporosis

With aging, calcium in the bones gradually depletes, bone density decreases, and bones become fragile and prone to fractures. Regular sun exposure can promote vitamin D synthesis, which enhances calcium absorption.

5. Hyperthyroidism

Hyperthyroidism, often caused by weakened immunity or unhealthy lifestyle habits, leads to abnormal bone metabolism, resulting in osteoporosis and reduced bone mass, thus increasing fracture risk. Symptoms commonly include frequent urination and weight loss. Patients may take medications such as methimazole tablets, propylthiouracil tablets, or propranolol hydrochloride tablets as prescribed by a physician.

II. Conservative Treatment Methods

1. Manual Reduction and Immobilization

In cases where the fractured segments are relatively well-aligned, manual reduction may be used. Through techniques such as traction, pulling, lifting, and realignment, overlapping, lateral, angular, or rotational displacement of the fracture can be corrected. After successful reduction, immobilization is typically achieved with a small splint. This procedure must be performed by qualified medical professionals to ensure accuracy and safety.

2. Bed Rest and Limb Elevation

After a fracture, elderly patients require bed rest and should avoid early weight-bearing activities or heavy physical labor. Elevating the affected limb helps promote venous return and reduce swelling.

3. Dietary Adjustment

Elderly individuals should increase their nutritional intake after a fracture, consuming foods rich in calcium, protein, and vitamins—such as milk, eggs, lean meat, fresh vegetables, and fruits. These nutrients support bone regeneration and healing of surrounding soft tissues.

4. Functional Exercises

Under medical supervision, active functional exercises—such as joint flexion and extension, and muscle contraction—should be performed. These exercises help prevent muscle atrophy and osteoporosis, enabling simultaneous fracture healing and functional recovery.

5. Traditional Chinese Medicine (TCM) Therapy

Herbs such as *Eupolyphaga sinensis* (Tubiechong), *Drynariae rhizoma* (Gusuibu), and *Corydalis yanhusuo* (Yanhusuo) have effects of promoting blood circulation, reducing swelling, removing blood stasis, mending tendons and bones, and relieving pain. They can accelerate fracture healing and alleviate fracture-related pain, but must be used according to medical advice.

In daily life, elderly individuals should maintain appropriate physical activity to enhance reaction time and balance, focus on balanced diets and nutritional supplementation—especially adequate intake of calcium and vitamin D—and undergo regular health check-ups to prevent fractures.