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Pathological fractures leave man bedridden

2021-09-23  Paheja Siririka

Pathological fractures leave man bedridden
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An Okakarara-born carpenter has been bedridden and unable to provide for his family for four months because of the unusual and spontaneous fracturing of his bones.

 “I accidentally bumped myself against the sofa and my leg broke. On a separate occasion, my other leg broke out of the blue and as I leaned on something for support, that’s when my arm broke. For the other arm, I was being massaged to loosen the muscle tension and it also broke.”

This is the horrific tale of Kateopora Kuhanga (52) telling Vital Signs from his bed of how he was perfectly fine one moment and bedridden the next.

He first broke his leg in December 2020 and the rest followed. Doctors have not yet diagnosed his condition.

“I used to work with my hands; now, life has become more difficult, as I can’t make money. I can’t maintain this type of lifestyle. I used to make enough but now the situation has deteriorated that I am in diapers,” mumbled Kuhanga.

Kuhanga is married to Mbukamuna (37), and they have three children, aged six, 12 and 13, who are helpful when it comes to catering to their father’s needs.

Kuhanga said he has come to terms with his condition, and he would appreciate an adequate bed that would at least allow him to be comfortable, and some funds to buy medicine.

Orthopaedic surgeon at the Katutura state hospital Dr Tufikifa Nakale told Vital Signs that pathological fractures occur in any bone that is diseased, which leads to the weakening and loss of bone density that eventually creates easy breakage.

One of the causes of bone breaking is benign conditions that are not cancerous, a fluid-filled sack that weakens the bone, which can lead to breakage or fracturing.

“Another reason is any patient with a malignant tumour, which is multiple abnormal cells that are growing at an accelerated rate – and if it is within the bone, it will weaken the normal part of the bone, which can also lead to a fracture,” detailed Nakale.

Fragility fractures are also part of the pathological fractures for conditions like osteoporosis, where the weakening of bones is due to the loss of bone mineral density, which includes low calcium and vitamin D, signs which are common in the older generation, especially females during the post-menopause phase.

 

Age factor

“As you age, you are not as mobile, so you start losing bones because you are not using them. If you are not mobile, your bone mineral density will go down,” said Nakale.

He added that with the female population, because of the hormonal and post-menopausal changes in the body, doctors have noticed that all of these affect bone quality and density, which start decreasing, further leading to bone weakening, which results in fractures.

He added that one of the ways of avoiding this is keeping busy and taking walks; the elderly can also take mini walks instead of being immobile the whole day – and not necessarily be homebound but to stimulate the bone and to eat healthily.

Treatment

Nakale explained that all of these depend on the underlying conditions, which determine the type of treatment best suitable for a patient.

The benign condition is commonly found or seen in younger patients most of the time; their fractures are immobilised.

“We find a way to keep it still so it doesn’t move and it usually heals. When it comes to fragility fractures like Osteoporosis and Paget’s Disease, they are managed by giving patients supplements to strengthen the bone, especially osteoporosis in females. We give them calcium and Vitamin D – and if the bone mineral density is low, there are other drugs like Bisphosphonate that we administer.”

He said, recovery depends on when the condition is caught – but mostly, it resorts to palliative care, making the patient comfortable.

Nakale detailed: “It can include surgery, where bones are stabilised – or radiation and chemotherapy to minimise the pain they have and improve their function as well as stabilising the bones so that they are functional to get out of bed and move around”.

Warning signs

Nakale said the general population should be wary of their loved ones and themselves, as there are warning signs they can pick up, which may indicate the person might be experiencing pathological fractures.

“The warning signs can be a person experiencing pain, especially at night in any part of the body. Night-time pain is a tell-tale sign of something serious going on. Persons with constitutional symptoms like unexplained weight loss, night sweat and loss of appetite can be crucial signs to tell something is happening in the body.” 

He stated that people should pay more attention to swelling, and that mass growing might be a sign.

The doctor cautioned the public to be on the lookout for such signs so they can present themselves early to a hospital, instead of sitting at home and developing fractures that could have been avoided.

-         psiririka@nepc.com.na


2021-09-23  Paheja Siririka

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