HELLO.

I'M JENNIFER BLOMQVIST AND WELCOME TO HEALTHLINE THIS TUESDAY EVENING.

I'M SO GLAD YOU JOINED US.

I HAVE THE PRIVILEGE OF HOSTING THE SHOW TONIGHT AND WE DO HAVE A GUEST AS WE DO EVERY WEEK WHO WILL BE JOINING US REMOTELY BECAUSE WE'RE STILL IN THE MIDDLE OF A PANDEMIC AND SO JUST TAKING SOME SAFETY PRECAUTIONS WE'RE GOING TO HOLD OFF ON HAVING THE GUEST LIVE IN THE STUDIO WITH US.

BUT I AM LIVE IN THE STUDIO AND WE WILL TAKE YOUR QUESTIONS LIVE DURING THE SHOW.

SO THERE'S THE PHONE NUMBER TO CALL FROM NOW TILL ABOUT EIGHT O'CLOCK IT'S NINE SIX NINE TWO SEVEN TWO ZERO.

IN CASE YOU'RE OUTSIDE OF FORT WAYNE, IT'S STILL A FREE CALL AS LONG AS YOU PUT AN EIGHT SIX SIX IN FRONT OF THERE.

I HAVE TWO OPTIONS WHEN YOU CALL IN YOU CAN EITHER ASK THE QUESTION LIVE DURING THE SHOW WHICH IS PERFECTLY FINE A VERY EASY OR IF YOU PREFER THAT I ASK THE DOCTOR THE QUESTION FOR YOU THAT'S FINE WHEN YOU CALL IN THE PERSON WHO ANSWERS THE PHONES, WE'LL JUST TALK TO YOU ABOUT WHAT YOUR QUESTION IS AND PASS THAT INFORMATION ALONG TO ME THE TOPIC TONIGHT IS ORTHOPEDICS, WHICH IS ALWAYS A VERY POPULAR SHOW AND WE USUALLY GET A LOT OF CALLS.

SO I WOULD SAY IF YOU HAVE A QUESTION CALL SOONER RATHER THAN LATER.

I'D HATE TO MISS YOUR CALL.

SO LET'S GO AHEAD AND MEET OUR GUEST WHO'S BEEN KIND ENOUGH TO GIVE UP HIS TIME TONIGHT, DR. JAMES DANIELS WHO IS AN ORTHOPEDIC SURGEON.

THANK YOU SO MUCH FOR JOINING US AND THANK YOU FOR HAVING ME.

YOU WANTED TO FOCUS ON THE TOPIC OF FRAGILITY FRACTURES AND I WONDER IF YOU CAN JUST BRIEFLY DESCRIBE WHAT WHAT EXACTLY THAT IS NOT TYPICALLY WHAT YOU JUST DESCRIBED REALLY FRACTURES IS FRACTURE OR BREAK OF A BOMB.

THAT'S WEEKEND.

TYPICALLY WE SEE THIS PROCESS AS WE GET A LITTLE OLDER A BONE GETS WEAKER.

WE ALSO HAVE OTHER CAUSES THAT LEAD TO WEAKENED BONE AND AND HENCE THE FRAGILITY FRACTURES SO THAT CERTAIN AREAS OF THE BODY THAT ARE MORE PRONE TO DEVELOPING STINGILY FRACTURES.

SO IT'S NOT NECESSARILY FROM SOME KIND OF A TRAUMA OR FALL NECESSARILY.

IS THIS JUST SOMETHING THAT KIND OF YOU I GUESS FOR LACK OF A BETTER TERM JUST KIND OF STIRS UP AND THEN EVENTUALLY JUST JUST BECOMES A FRACTURE?

IT CAN BE BOTH.

YEAH, WE CAN SEE PATIENTS WHO DID DEVELOP SPONTANEOUS FRACTURES SOMETIMES IF THE SPINE IS MORE COMMON TO HAVE FRACTURE BUT OTHER ONES WHERE IT USUALLY TAKES LOW ENERGY TRAUMA WE CAN GET FRACTURES OF THE PELVIS WHERE WOMEN IN THEIR 20S, 30S AND WE HAVE THE SAME TYPE OF FALL.

WE'RE NOT GOING TO HAVE HEAD INJURY.

SO HOW DOES THIS DIFFER FROM OTHER KINDS FRACTURES?

IS THERE A DIFFERENT WAY TO TREAT THEM THAT TREAT PATIENTS WITH THIS?

YEAH, A REALLY GOOD QUESTION DEPENDING ON THE TYPE OF PATIENT AND WHERE THE FRACTURE IS OF SPECIAL CONSIDERATIONS.

WE TALK ABOUT FIXING THESE TYPES OF FRACTURES.

WE HAVE SPECIAL IMPLANTS THAT ARE DESIGNED TO BE STRONGER HOLDING UP THIS TYPE OF WE CAN BONE FRACTURES OF CERTAIN AREAS AROUND JOINTS WE MAY HAVE TO CONSIDER DOING REPLACEMENT AS A FIXATION TO ALLOW WEIGHT BEARING EARLY ON AFTER THIS FRACTURE INJURY.

WHAT NOW IF SOMEBODY IF SOMEBODY DOES HAVE THIS KIND OF A FRACTURE, COULD IT HAPPEN AND THEY MIGHT NOT REALLY REALIZE SOMETHING IS BROKEN, THEY JUST MAYBE HAVE SOME PAIN AND NOT REALLY REALIZE THAT THEY'VE BROKEN SOMETHING?

YEAH, WE CAN SEE PATIENTS WHO HAVE A LOW ENERGY FALL WHERE AGAIN THEY MIGHT NOT AND THAT'S OK. THAT'S A FORM HAVING SUSTAINED AN INJURY FOR INSTANCE, THEY FALL AND THEY HAVE SOME PAIN IN THEIR GROIN, MAYBE A LIMITATION IN THEIR ABILITY TO PUT FULLY ON IT AND THEY MIGHT NOT THINK THEY HAVE SOMETHING AND IF THAT GETS WORSE AS AS THEY WALK AND PUT MORE WEIGHT ON IT, THEY GET AN X-RAY AND FIND OUT IF THEY HAVE A HIP FRACTURES SORT OF OTHER TYPE OF INJURY.

WELL, I KNOW I AM GUILTY OF THIS AS WELL BUT IF YOU HAVE SOME KIND OF AN INCIDENT OR SOME PAIN, YOU THINK I'M JUST GOING TO RIDE IT OUT FOR A WHILE?

I DON'T THINK IT'S ANYTHING.

MAYBE IT'LL JUST GO AWAY.

ARE YOU DOING ANY MORE DAMAGE IN THE LONG RUN IF YOU EVEN WAIT LIKE A DAY OR SO BEFORE GETTING IT CHECKED OUT NOT POTENTIALLY TO HAVE ONE BROKEN UP HIP FRACTURES BECAUSE THAT'S WHERE THE MOST COMMON FRAGILITY FRACTURE WE SEE AS WE GET OLDER SO THEY CAN TURN A FRACTURE THAT WE CAN POTENTIALLY FIX INTO SOMETHING WE HAVE TO REPLACE.

SO IF YOU'RE IN SITUATIONS OF AS WE'RE GETTING OLDER AND WE HAVE YOUR BONE IN A MORE PRONE TO GET CHECKED OUT EARLIER, AT LEAST GET AN EXTRA DAY, JUST MAKE SURE THERE'S OK ON THE SIDE OF CAUTION IS WHAT IT SOUNDS LIKE.

DR. DANIELS, WE DID HAVE SOMEBODY WHO WANTED TO ASK YOU A QUESTION LIVE SO I'M GOING TO TOSS IT OVER TO CHUCK.

CHUCK, ARE YOU STILL THERE?

I AM HERE, YOUNG LADY.

HELLO.

WELL, I'M NOT THAT YOUNG BUT THANK YOU.

GO HEY, I'M 71 AND YOU'RE A LOT YOUNGER THAN ME.

NOT TOO MUCH BUT THANKS FOR THE COMPLIMENT.

GO AHEAD WITH YOUR QUESTION CHUCK.

OKAY.

YEAH I'VE BEEN USING A IANAL DETOX MACHINE.

ARE YOU FAMILIAR WITH THOSE AND I'M NOT THIS I'VE BEEN USING THIS NOW FOR THREE YEARS.

I SIMPLY PUT MY FEET INTO THIS MACHINE AND I GET TO ADD A LITTLE BIT OF SALT TO IT TO KIND OF GET TWEAK IT OUT AND I HAVE NOT HAD ANY ACHES AND PAINS IN OVER TWO YEARS.

OK, YEAH I'M ALL FOR SOME OF THESE YOU KNOW LET'S STICK TREATMENTS OR OTHER OFF OFF THE CUFF TREATMENTS ANYTHING THAT WORKS AND YOU KNOW THE DIFFERENCE I THINK IT'S WORTH IT.

I CAN SAY THAT THERE'S SPECIFIC MEDICAL LITERATURE PERTINENT TO THAT AND JUST BECAUSE IT'S NOT SOMETHING I TYPICALLY STUDY ON THIS WORK FOR SOME GO FOR CHECK DID YOU WANT TO ASK ANYTHING ELSE OR SAY ANYTHING?

NO, NO.

I JUST TRULY BELIEVE IN THE MACHINE AND THANK YOU FOR THIS SHOW.

IT'S JUST WONDERFUL.

OH, I'M GLAD YOU ENJOY IT.

THANKS SO MUCH FOR WATCHING.

WE APPRECIATE.

ALL RIGHT.

WHAT THAT WAS CHUCK AND YOU KNOW I GUESS BEFORE WE GO ON WITH THE SHOW, YOU KNOW, HE DOES BRING UP A GOOD POINT.

THERE'S A LOT OF STUFF THAT YOU CAN BUY WITHOUT GETTING A PRESCRIPTION.

DR. DANIELS, THIS LIKE THIS MACHINE HE MUST HAVE JUST BOTTLE OVER THE COUNTER.

IS IT A GOOD IDEA THOUGH TO CHECK WITH YOUR PHYSICIAN FIRST OR MOST OF THESE THINGS PROBABLY PRETTY HARMLESS.

YEAH.

I MEAN I THINK IT'S ALWAYS GOOD TO CHECK WITH YOUR PHYSICIAN THE SAME IN SITUATIONS LIKE THIS WHERE MAYBE THAT'S SOMETHING I'VE HEARD OF .

SOMETIMES YOU GET THAT WITH OVER-THE-COUNTER CREAMS OR HOMEOPATHIC MEDICATIONS OR THINGS THAT MIGHT PROMOTE BONE MARROW.

THERE ARE SO MANY LOWER FRACTURE RISK PATIENTS DO WELL ON THAT AND AND DON'T SEE ANY HARMFUL SIDE EFFECTS.

I'M NOT ONE THAT'S GOING TO TELL THEM TO STOP DOING THAT.

I JUST ENCOURAGE THEM TO NOT SPEND ALL THEIR MONEY ON SOMETHING UNLESS UNLESS UNLESS IT'S PROVEN OR UNLESS THEY'RE SAYING THOSE POSITIVE SIDE EFFECTS.

ALL RIGHT.

WELL CHECK MOUTHWASH A LOT OF LATE NIGHT TV BECAUSE I KNOW I DO AND I'VE SEEN SOME PRETTY QUIRKY THINGS ON THERE.

SO MAYBE THAT'S WHERE HE FOUND THAT DEVICE.

THERE WAS ONE OTHER PERSON WHO CALLED TO ASK YOU A QUESTION BUT THEY WANTED ME TO ASK FOR THEM.

SO IT WAS A WOMAN NAMED ROSIE.

HER QUESTION IS WHAT WOULD CAUSE A GRINDING SOUND IN THE NECK THAT DOESN'T ALSO INVOLVE PAIN?

NO, IT'S A LITTLE VAGUE BUT YEAH.

YEAH, YEAH, HARD TO SAY.

I MEAN UNFORTUNATELY A SPINE WOULD NOT BE MY SPECIALTY BUT WE GET BOTH SOME ARTHRITIS AND HAVE SOME ACHES AND PAINS.

WE SEE A KNEE, WE SEE IT OTHER JOINTS SPINE IS MADE UP OF A BUNCH OF JOINTS SO AS SOME ARTHRITIC WE CAN HAVE SOME OF THOSE PAINS OR GRINDING SOUNDS THAT MAY NOT ACTUALLY CAUSE DISCOMFORT.

ALL RIGHT.

WELL THANK YOU TO ROSIE FOR CALLING AND THANKS TO CHUCK AS WELL.

I WANT TO REMIND EVERYBODY ELSE THE PHONE LINES ARE OPEN.

WE'RE ONLY HERE TILL ABOUT EIGHT O'CLOCK SO THERE'S A NUMBER WE KEEP IT UP AT THE BOTTOM OF THE SCREEN FOR YOU NINE SIX NINE TO SEVEN TO ZERO.

WE ARE TALKING ABOUT FRAGILITY FRACTURES BUT IF YOU HAVE SOMETHING ALONG THOSE LINES OR ORTHOPEDIC RELATED, FEEL FREE TO GIVE US A CALL.

WANTED TO CONTINUE ABOUT OUR DISCUSSION ABOUT THE FRACTURES I KNOW BEFORE THE PROGRAM YOU AND I WERE TALKING ABOUT HOW A LOT OF TIMES YOU WILL DEAL WITH TRAUMA PATIENTS MAYBE SOMEBODY WHO'S BEEN IN A CAR ACCIDENT OR HAD SOME TYPE OF A SERIOUS FALL AND YOU COULD BE LOOKING AT A PATIENT WHO HAS MULTIPLE FRACTURES SO WHAT ALL DOES THAT INVOLVE IF THERE'S MORE THAN ONE BREAK?

WELL, GOOD QUESTION.

YOU KNOW, WHEN WE TALK ABOUT FRAGILITY FRACTURES, I MENTIONED HIP FRACTURES.

WE CAN SEE FRACTURES OF THE PELVIS FROM LOW ENERGY FALLS, PELVIS FRACTURES.

WE IN THE YOUNGER AGE GROUP WE TYPICALLY SEE SOME HIGHER INJURY INJURIES WHERE WE HAVE PELVIC FRACTURES AND THEN ASSOCIATED LONG BONE INJURIES.

UPPER EXTREMITY OF THE INJURIES IN THE YOUNGER AGE GROUP IT USUALLY TAKES A LOT MORE TRAUMA AND THE OLDER AGE GROUP IF SOMEONE HAS MORE YOU CAN BONE IT COULD BE VERY SIMPLE FOLLOW A COUPLE OF SO MANY THESE PATIENTS COME IN AND MAYBE SOME SIMPLE FALL.

IT'S IMPORTANT NOT JUST TO CHECK WHERE THEY'RE HURTING BUT HISTORY SEE OTHER AREAS THAT MIGHT HURT AND AND SOMETIMES YOU FIND OUT THAT THERE'S AN ASSOCIATED INJURY ON BOTH LOWER AND LOWER EXTREMITY THAT WE JUST CERTAIN TREATMENT PATHWAY WHERE MAYBE WE WOULD FIX THEM AND THEN SLOWLY.

BUT IF THEY HAVE TWO INJURIES WE MIGHT HAVE A DIFFERENT SITUATION AND THEN OUR DOES THAT TIE IN WITH PEOPLE THAT MAY NEED SOME JOINT REPLACEMENT FOR THESE TYPES OF FRACTURES OR DOES THAT JUST VARY ON THE BREAK OR MAYBE A PERSON'S AGE?

IT'S THE VERY QUESTION THAT WITH HIP FRACTURES KNOW PATIENTS DEPENDING ON WHERE THEY BREAK IN THE HIP IF IT'S INSIDE THE JOINTS AND THERE IS A CERTAIN AGE GROUP WE CONSIDER HIP REPLACEMENT SURGERY IS TO FIXATION ON THE HIP IS NOT A VERY GOOD HEALING BONE WHEN IT'S INSIDE THE JOINT.

SO A LOT OF TIMES WE ASK FOR HIP REPLACEMENT SURGERY AND PATIENTS UNDER THE AGE OF 50 WE WANT TO PRESERVE THE HIP FOR AS LONG AS THEY CAN.

AS WE GET OLDER WE START CONSIDERING MORE HIP REPLACEMENT SURGERY IF PATIENTS ARE GOING TO BE ACTIVE FOR A LONG PERIOD OF TIME, CONSIDER DOING REPLACEMENT WHICH WOULD BE FIXING BOTH SIDES OF THE HIP JOINT BECAUSE WE DON'T WANT TO WEAR OUT ONE SIDE OVER TIME AS WE GET EVEN OLDER AND MAYBE WE'RE NOT THE PATIENTS NOT AS MOBILE CAYS LAND IS THEN CAN MAYBE DO A PARTIAL REPLACEMENT BECAUSE THEY KNOW THEY MIGHT NOT WEAR OUT THE OTHER END JOINTS OVER TIME NOW FOR THE JOINT REPLACEMENT IF YOU GO THAT ROUTE IS THAT TECHNICALLY PERMANENT THAT TYPE OF HARDWARE OR DOES IT HAVE A CERTAIN LIFESPAN AND THEN NEED TO BE REPLACED AGAIN, CORRECT?

YEAH, PERMANENT HARDWARE.

SO WHEN WE GO DOWN THAT ROAD THAT'S WHY WE CONSIDER YOUR AGE WE DO HAVE REPLACEMENT SURGERY NOW THE GOAL IS TO GET PATIENTS IMMEDIATELY WEIGHT BEARING AFTER THEIR INJURY AGAIN TALKING SPECIFICALLY ABOUT HIP FRACTURES.

WE WANT THEM TO BE IMMEDIATE WEIGHT BEARING SO THEY CAN RECOVER AS WE GET OLDER.

THAT'S MORE IMPORTANT WHERE PATIENTS IF THEY CAN'T FIT IMMEDIATELY THEY MIGHT HAVE A HARD RECOVERY .

AND OUR GOAL WITH EVERY SURGERY IS THAT HOPEFULLY WITH REPLACEMENT SURGERY THEY'LL NEVER NEED SURGERY AFTER THAT ALL RIGHT.

WELL, WE DID HAVE I DO WANT TO TALK ABOUT THEIR OPTIONS FOR RECOVERY AND THINGS THEY CAN DO TO OPTIMIZE THAT.

BUT WE DID HAVE SOMEBODY WHO WANTED ME AGAIN TO ASK YOU THE QUESTION FOR THEM.

A GENTLEMAN NAMED JOHN CALLED AND HE WANTED TO KNOW WHAT COULD CAUSE EXTERNAL SWELLING IN HIS CLAVICLE AREA.

OK, WELL KIND OF DEPENDS ON IF HE HAS AN INJURY.

USUALLY IF WE HAVE AN INJURY WE CAN HAVE SWELLING FROM A FRACTURE AS A LOT THE MUSCLES THAT ATTACH TO THE CLAVICLE.

SO MUSCLE STRAIN SOMETIMES EVEN NEXT DRAINS OR MUSCLES FROM THE NECK AREA AND SO ON THE CLAVICLE SOMETIMES THERE CAN JUST BE COMPRESSION OF VESSELS THAT GO AROUND THE CLAVICLE OR WE CAN SEE SOME SWELLING BUT MORE OFTEN THAN THAT SEE THE MOST LIKELY COMMON REASON A KNOWN TRIAL WOULD BE SOME SORT OF MUSCLE STRAIN.

IS THAT SOMETHING THAT YOU CAN NORMALLY I MEAN WITH WITH MOST OF THE PATIENTS YOU SEE I WOULD I THINK YOU'D PROBABLY JUST HAVE TO START WITH TESTS FIRST OR ARE THERE WAYS THAT YOU CAN JUST BY EXAMINING THESE PATIENTS IDENTIFY THAT SOMETHING IS BROKEN OR DO YOU HAVE TO GO THE ROUTE OF X RAYS OR OTHER SCANS?

YEAH, TYPICALLY WE WILL ALWAYS GET AN X RAY IF SOMEONE HAS A MUSCATEL COMPLAINT IT'S KIND OF THE VERY BASIC TEST WE CAN GET RID OF ANYTHING BIG.

NOT ONLY CAN WE SEE BONE BUT WE CAN SEE CERTAIN THINGS THE SOFT TISSUE, WE CAN SEE PARTS OF THE LUNG AND WE'RE GOING TO CLAVICLE X RAY IT'S FULL ALL SWELLING OR A MASS OR LAUGHING AT SOME POINT WE'RE LOOKING SECTION OR SOMETHING ELSE BUT NOT SURE IS PRETTY MUCH A GOOD STANDARD SCREENING TEST THAT WE GET FOR THIS PATIENT IS THE LATEST PATHWAY.

ALL RIGHT.

I DID WANT TO REMIND EVERYBODY WE DON'T HAVE ANYBODY WAITING TO ASK A QUESTION RIGHT NOW IF YOU WANT TO CALL IN, FEEL FREE TO DO SO.

WE HAVE A FEW MINUTES LEFT.

WE COULD SQUEEZE IN A FEW QUESTIONS.

SO THERE'S A NUMBER AGAIN NINE SIX NINE TO SEVEN TO ZERO AND AGAIN, DR. DANIELS IS AN ORTHOPEDIC SURGEON IF YOU HAVE ANYTHING ORTHOPEDIC RELATED, FEEL FREE TO GIVE US A CALL.

WE KIND OF TOUCHED ON THIS A LITTLE BIT BEFORE BUT JUST OPTIMIZING RECOVERY FOR THESE PATIENTS WHO HAVE THESE FRACTURES SO THIS IS SOUNDS LIKE SOME OF THESE INJURIES COULD TAKE A WHILE BEFORE THEY HEAL.

YEAH.

AND WHEN WE TALK ABOUT HIP REPLACEMENT SURGERY OR ANY SORT OF JOINT REPLACEMENT SURGERY, THE GOAL IS TO GET PATIENTS UP AND MOVING SOONER WITH THE FRACTURES WE TALK ABOUT QUICK REPLACEMENT SURGERY AND THE GOOD THING ABOUT THAT IS WE DON'T NEED ANY BONE HEALING AND WE CAN GET THEM PUTTING WEIGHT ON IT RIGHT AWAY TRYING TO SPEEDY RECOVERY AND THEY HAVE OTHER INJURIES IN OTHER AREAS OF THE BODY SUCH AS A WRIST FRACTURE IF THEY HAVE A FRACTURE AND HIP FRACTURE WHERE WE TYPICALLY NEED TO SURGICALLY TREAT THAT WRIST FRACTURE MAY BE IMPORTANT IN THEIR RECOVERY SO THEY CAN USE A DURING THE LONGER THAT WE NEED OPERATIVELY TO FIX IT TO LOVE ME LATER.

I AM ALWAYS AMAZED BY HOW QUICKLY YOU KNOW I HEAR SOMEBODY SAY THEY HAD MAYBE HIP REPLACEMENT SURGERY OR HAD AN INJURY.

YOU WERE TALKING ABOUT HOW YOU WANT THEM TO BE WEIGHT BEARING VERY SOON.

THAT ALWAYS JUST SEEMS SCARY TO ME AND THAT IT WOULD BE PAINFUL.

BUT YOU'RE SAYING IN THE LONG RUN IF YOU DON'T DO IT THAT WAY YOU DECREASE YOUR CHANCES OF HAVING A FULL RECOVERY .

YEAH, IT'S KIND OF THE WHOLE PURPOSE OF OUR SURGICAL TREATMENTS.

YEAH.

WE WANT TO GET EARLY LABORITE MORE MOBILIZATIONS WANT JOINTS TO MOVE.

THEY TELL PEOPLE OFTEN IT'S LIKE WE'RE TESTING THE BONE ON THE INSIDE WHEN WE FIX FRACTURE WE WANT TO ALLOW JOINT MOTION MOBILITY EVEN IF IT'S NOT WEIGHT BEARING, JUST AN OPTIMIZED RECOVERY .

SO SOMETIMES THAT MEANS WE FIX THINGS WHEN THEY CAN STILL DO WELL ON ITS OWN WITHOUT SURGERY AND THEY MIGHT HAVE A BETTER FUNCTION IF WE FIX IT AND ALLOW THEM TO MOVE IT RIGHT.

AND THEN AFTER THAT AFTER A HOSPITAL STAY ARE PEOPLE LOOKING AT WEEKS OR MONTHS OF PHYSICAL THERAPY OR WHAT WOULD WITH THE TYPICAL PROTOCOL BE FOR THEM?

YOU KNOW, DEPENDING ON THE INJURY AND SURGERY, YOU KNOW, WITH WITH HIP SURGERY OR ELBOW SURGERY THOSE PATIENTS UP AND WALKING.

THAT'S MY PRIMARY GOAL.

LOOK FOR MOBILIZATIONS, THINGS LIKE THAT DEPENDING ON THE TYPE OF FRACTURE I'M A LITTLE SLOW WITH THERAPY.

I KIND OF WANT THEM TO DO THINGS ON THEIR OWN OR FIND AND GET UP AS WE START TO HEAL ALONG A LITTLE BIT MORE IF SOMETHING WE FIX THEM WE CAN GET A LOT MORE AGGRESSIVE FOUR TO SIX WEEKS DOWN THE ROAD THERE'S A LITTLE BIT MORE STABILITY FOR ME BUT KIND OF A RULE OF THUMB FOR ME AND WITH SOMEONE WITH AN INJURY AS I SAY THREE MONTHS ARE GOING TO BE ABOUT EIGHTY PERCENT RECOVERED AND MIGHT BE A FULL SIX MONTHS BEFORE THEY GET CLOSE TO ALMOST A HUNDRED PERCENT OR IS IT'S GOING TO GET BUT NOW I WAS WONDERING SOME OF YOUR COLLEAGUES IN YOU KNOW, IN PAST SHOWS HAVE ALWAYS SAID SOMETIMES THAT, YOU KNOW, YOU'LL HAVE AN INJURY WHEN YOU'RE 50 AND IT DIFFERS GREATLY FROM SOMEBODY WHO'S MAYBE HALF THEIR AGE.

TWENTY FIVE.

SO IN GENERAL I MEAN DO USUALLY WITH THESE TYPE OF FRACTURES GET PRETTY CLOSE TO THE WAY IT WAS BEFORE OR MAYBE YOUR ACTIVITY LEVEL COULD BE THE SAME AS BEFORE THE INCIDENT.

YEAH, AND WE'RE ALWAYS STRIVING TO GET TO THAT FOR PATIENTS, YOU KNOW WHETHER IT'S THE TYPE OF HIP FIXATION SOMETIMES IN ELDERLY PATIENTS IT'S THE SAME PELVIC FRACTURES AND FRACTURES ARE SOMETHING WE HAVEN'T TREATED OPERATIVELY BUT THERE ARE NEW TECHNIQUES WHERE WE CAN PERCUTANEOUSLY FIXED FRACTURES TO KIND OF STABILIZE MERLY SO PATIENTS CAN MOBILIZE AND THEN WE CAN GET THEM DOING AN EARLY WEYBURN AND THE TREATMENT OPTIONS WERE MAYBE IN TWENTY THIRTY YEARS AGO THEY WERE JUST ALLOWING THE BONE TO HEAL AND AS FAR AS IT GOES THROUGH THE PROCESS, YOU KNOW, TWO, THREE MONTHS.

ALL RIGHT.

I DID WANT TO TURN IT OVER TO ANOTHER QUESTION FROM A VIEWER.

SOMEBODY NAMED MEG CALLED IN AND SHE WANTED ME TO ASK IF YOU CAN EXPLAIN THE DIFFERENCE BETWEEN A NORMAL FRACTURE AND A STRESS FRACTURE AND WOULD SURGERY BE NEEDED TO CORRECT EITHER OF THOSE?

YEAH, A NORMAL FRACTURE AND A LOT OF PEOPLE WILL BRING THIS UP TO US.

YOU KNOW, THEY HERE SAY THEY SEE DIFFERENCE FRACTURE AND BREAK AND IS WHERE WE KIND SEE AND IT'S THE SAME THING IN ADULTS WE TYPICALLY BREAK THE BONE ALL THE WAY THROUGH.

SO IT'S IMPORTANT THAT SHE SAID STRESS FRACTURE BECAUSE THAT'S A RARE INSTANCE WHERE WE DON'T FULLY BREAK THROUGH AND THERE'S AND WE CAN SEE FINDINGS ON X RAY MAYBE THE BONES OR THE WEEKEND OR IT'S REACTING TO A PARTIAL FRACTURE DEPENDING ON WHERE IT'S AT IF IT'S A WEIGHT BEARING PORTION AND OFTEN WE SEE THIS SOMETIMES IN THE HIP OR AT THE TOP OF THE FEMUR PATIENTS DEVELOP STRESS FRACTURES THAT WE DO OFTEN RECOMMEND SURGICAL SURGICAL STABILIZATION WE CAN DO INCREMENTALLY FIXATIONS OR SOMETHING TO MINIMALLY INVASIVE SUPPORT THE BONE TO ALLOW THEM TO IMMEDIATELY WAYFAIR AND WE KIND OF TAKE THE STRESS OFF THE BONE SO THAT THE BONE CAN HEAL ITSELF AND RELIES ON THE METAL THAT'S ON THE INSIDE.

AND I'M JUST WONDERING FOR SOME FOR SOME OF THE THE FRACTURES THAT YOU'RE TALKING ABOUT, ESPECIALLY ONES THAT IT SOUNDS LIKE IT JUST KIND OF IS AN ONGOING ISSUE AND THEN IT RESULTS IN A FRACTURE.

I MEAN ARE THERE THINGS PEOPLE CAN DO TO TRY AND PREVENT THAT FROM HAPPENING?

I THINK YOU HAD MENTIONED EARLIER IN THE SHOW MAYBE LIKE SOMEBODY WITH OSTEOPOROSIS, YOU KNOW, BEING PRONE TO ONE OF THESE ISSUES.

YEAH.

AND YOU KNOW, TYPICALLY THE FIRST TREATMENT OR SUPPLEMENTATION WE SAY CALCIUM AND VITAMIN D SUPPLEMENTATION AND A LOT OF PATIENTS IN THE MIDWEST WE DON'T GET A LOT OF SUNLIGHT.

WE'RE VITAMIN STATION AND THAT'S PATIENTS OF ALL AGES THAT AS WE GET OLDER AS WE GET TO THE AREA WHERE MAYBE WHERE WE'VE HAD A FRAGILITY FRACTURE OR AT RISK OF OSTEOPOROSIS, THERE ARE MEDICATIONS IS PART OF THIS LARCENOUS THAT CAN HELP INCREASE BONE DENSITY AND LIMIT THE RISK OF DEVELOPING A FRACTURE.

THAT BEING THAT I WAS JUST MENTIONED IN THE STRESS FRACTURE IS SOMETHING THAT'S KIND OF IMPORTANT LIKE THIS LAST MINUTE USE THAT WE'RE SEEING THAT SOME PATIENTS HAVE BEEN FOR A LONG TIME MAYBE OVER FIVE YEARS WITHIN THEN TO PROCESS MEDICATIONS SUCH AS THIS FASCINATES AND THEY DEVELOP A STRESS FRACTURE BECAUSE OF MEDICATION.

ALL RIGHT.

AND DO YOU FIND IT IS IT MORE OF AN ISSUE THESE TYPES OF FRACTURES, MORE OF AN ISSUE WITH MEN OR WOMEN AS FAR AS YOU'RE TALKING ABOUT THINGS LIKE OSTEOPOROSIS, THOSE ARE TEND TO BE A DIFFERENCE BETWEEN THE SEXES.

YEAH, TYPICALLY WOMEN ARE AT HIGHER RISK ONE IN THREE WOMEN OVER THE AGE OF 50 OR RISK OF DEVELOPING A CHRONIC FRAGILITY FRACTURE WHERE IT MIGHT BE ONE IN FIVE MEN.

THE DIFFERENCES ON BONE MARROW MINERAL DENSITY INITIALLY AND AFTER MENOPAUSE ABSURDISM LEVELS DROP AND FEMALES CAN BECOME AT HIGHER RISK OF DEVELOPING OSTEOPOROSIS.

AND I WAS WONDERING IF ISSUES LIKE THAT TEND TO BE HEREDITARY.

YOU KNOW, IF YOU'RE GRAD BECAUSE I I'VE SEEN THAT IN FAMILIES SOMETIMES WHERE YOU KNOW ALL THE WOMEN AS THEY GET OLDER THEY'RE DEFINITELY HUNCHED OVER MORE WITH THAT OSTEOPOROSIS ISSUE.

SO DOES IT TEND TO BE HEREDITARY OR NOT?

THAT IS ONE OF THE RISK FACTORS ARE CALL MY MY MODIFIABLE RISK FACTORS AND FAMILY HISTORY OF OSTEOPOROSIS FRACTURE OR OSTEOPOROSIS AND WE JUST DON'T KNOW THE REASON THEY TEND TO BE MORE PRONE.

OK, ALL RIGHT.

AND I DID WANT TO ADDRESS ANOTHER VIEWER QUESTION AGAIN ANOTHER MAN NAMED JOHN OR PERHAPS IT WAS THE SAME JOHN FROM BEFORE.

WOULD THIS MAN I WOULD LIKE TO KNOW IF STEM CELLS CAN BE USED TO REPAIR FRACTURES.

INTERESTING QUESTION.

I DON'T THINK WE KNOW THE ANSWERS TO THAT.

I THINK SOME OF THE BIOLOGICS WE USE IN ORTHOPEDICS WHERE WE DO GET CELLS FROM THE HUMAN BODY SOMETIMES WE HARVEST CELLS FROM THE PELVIS WHEN WE'RE TRYING TO GET IT TO HEAL FRACTURES THAT DON'T FEEL ON THEIR OWN THE FIRST TIME WE GOT FRACTURE NONUNION SO THAT'S AN IMPORTANT AREA WHERE STEM CELLS WOULD BE INFORUM TO HELP HEAL FRACTURES AND A LOT OF TIMES WE DO LIKE BONE MARROW ASPIRATIONS TO ASSIST HEALING WELL.

SO THAT CAN BE AN AREA WHERE IT IS IMPORTANT.

ALL RIGHT.

NOW WE ONLY HAVE LIKE MAYBE A MINUTE AND A HALF LEFT.

BUT REAL QUICKLY, MARY IS ON THE LINE.

MARY, DO YOU WANT TO QUICKLY ASK YOUR QUESTION?

MARY, ARE YOU STILL THERE?

YES, YES, YES.

I'M SORRY.

GO AHEAD.

OH YES.

I HAVE A QUESTION ON TIBIAL PLATEAU FRACTURES WHAT THE SUCCESS RATE IS FOR SURGERY FOR SOMEONE IN YOUR 60S.

VERY GOOD QUESTION.

YEAH, NO ONE LIKE THIS IN MY SPECIALTY SO I LIKE THAT AND I'M HEARING THAT INDURAIN TALKING ABOUT IT AND WE TYPICALLY HAVE GOOD SUCCESS RATE WITH GOAL IS TREATING TIBIAL PLATEAU FRACTURES IF WE WANT TO STABILIZE THE BONE AS IT WAS BEFORE YOU BROKE IT AND WE HAVE SPECIAL DEVICES THAT HELP FIX THOSE AND AND SOMETIMES THAT IS AND WE CAN BONE THAT'S AN AREA OF OUR MIND THAT GETS WEAKER.

SO WE HAVE SPECIAL PLATES THAT SCREWS ARE DESIGNED TO LOCK INTO THE PLATES TO GET RIGID SUPPORT AND HEAL THAT.

SO WE KNOW WE HAVE VERY GOOD SEX SEX SUCCESS OF HEALING THAT WHETHER THAT SUCCESS TURNS INTO BEING PAIN FREE WE CAN'T SAY ANY TIME WE BREAK INTO THE JOINT LIKE WE DO IN TIBIAL PLATEAU FRACTURES WE'RE AT HIGHER RISK OF DEVELOPING OUR SCRIPTWRITER'S IN THAT JOINT BECAUSE ONCE WE DAMAGE CARTILAGE IN THE JOINT WE CAN'T REVERSE THAT.

AND SO THE VOLUNTARY PLATEAU FRACTURES IS TO MAKE IT LOOK AS GOOD AS WE CAN SO WE CAN HEAL IT.

BUT IT DOESN'T NECESSARILY MEAN WE'RE ALWAYS ALL RIGHT.

THANK YOU, MARY, FOR THE QUESTION.

SADLY WE'RE JUST ABOUT OUT OF TIME, DR. DANIEL.

SO I APPRECIATE ALL THE QUESTIONS THAT A LOT OF VIEWERS THAT CALL IN TONIGHT AND I APPRECIATE THAT AND GLAD THAT THEY WERE ABLE TO BE POINTED IN THE RIGHT DIRECTION WITH THEIR QUESTIONS.

IN THE MEANTIME, I GUESS THE ADVICE FROM YOU IS TO JUST BE AWARE OF YOUR OWN HEALTH AND TRY TO AVOID THESE TYPES OF ISSUES IN THE FUTURE.

ABSOLUTELY.

FOLLOW UP WITH YOUR PRIMARY CARE DOCTOR ESPECIALLY THE HISTORY OF PREVIOUS FRACTURE OR FRAGILITY FRACTURE THE TINKERBELLE WILL TAKE CALCIUM AND VITAMIN D SUPPLEMENTATION IF YOU'RE AT RISK AND IF THERE ARE INDICATIONS ARE THERE ARE A CHANCE THAT YOU MIGHT HAVE OSTEOPOROSIS.

THERE ARE SOME PRETTY GOOD MEDICATIONS THAT CAN KIND OF LIMIT YOUR YOUR FRACTURES FUTURE.

WELL, LET'S HOPE FOR A SUNNY SPRING AND SUMMER.

WE GET SOME OF THE VITAMIN D NATURALLY AROUND HERE SO TAKE ADVANTAGE OF THAT.

DR. JAMES DANIELS, THANK YOU SO MUCH FOR JOINING US.

REALLY APPRECIATE YOUR HELP TONIGHT.

THANK YOU VERY MUCH FOR HAVING ME.

OH, SURE THING.

AND THANKS TO ALL OF YOU FOR AND THANKS TO ALL OF YOU FOR WATCHING.

I APPRECIATE YOU TUNING IN.

I'M JENNIFER BLOMQUIST.

THERE'LL BE ANOTHER HEALTHLINE ONE WEEK FROM TONIGHT NEXT TUESDAY SEVEN THIRTY IN THE MEANTIME, HAVE A GREAT REST OF YOUR WEEK AND BE SAFE AND HEALTHY.

WE'LL SEE YOU LATER.

BYE BYE.