Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of localized pain following minimal trauma. History significant for postmenopausal/senile osteoporosis, confirmed by prior DXA scan (T-score ≤ -2.5). No history of high-energy trauma. Pain is exacerbated by movement and weight-bearing. Associated symptoms include loss of height, kyphotic deformity, or localized tenderness over the affected site.
Clinical Examination Findings
Physical examination reveals localized bony tenderness, swelling, and ecchymosis at the fracture site. Assessment of gait shows antalgic pattern or restricted mobility. Neurological examination is intact distal to the fracture. Spine examination notes increased thoracic kyphosis or lumbar lordosis flattening. Vital signs stable; no signs of systemic infection or malignancy.
Treatment Protocol
Immediate management includes immobilization of the affected site, analgesia (NSAIDs or acetaminophen), and orthopedic consultation for potential surgical stabilization (e.g., vertebroplasty, kyphoplasty, or ORIF). Long-term management involves initiation of anti-resorptive therapy (bisphosphonates or denosumab) or anabolic agents (teriparatide), alongside calcium and Vitamin D supplementation. Fall prevention strategies and physical therapy referral are mandatory.