New Q for Mamboni, Neuro or other Docs

[beefsteak]

My oldest brother (79 going on 80) just had "broken hip surgery" on Sunday.

We've heard 3 terms we aren't familiar with, from the nursing staff, and I've tried looking them up on the net, but I either am not spelling it right or something. I just don't know what these mean. Please assist.

Please forgive the spelling.

Term one: diagnosis was "non-displaced and impacted."
What does that mean, please?

Term two: entrochanteric
What does that mean, please?

Term three: trochantic fracture

He's 79, and my twit for a sister-in-law claims it happened Friday morning and Surgery was Sunday morning, Jan

Is it possible the word impacted means it happened earlier than she is admitting to and she waited and waited long enough for this impacted situation to set up, i.e., just didn't call the ambulance when she should have?

Final Q:
Does any of this sound inconsistent with the story that he fell when stepping on his own foot while trying to use his walker?

Thanks for any help in our understanding. Frankly, the rest of my side of the house is trying to get a handle on whether or not my brother is a victim of elder abuse and we just haven't been paying enough attention to his living situation, and might need to "get involved" if you know what I mean.


beefsteak

[Serpo]

Every one uses big complicated words about simple things so it sounds more complicated than it really is.

If they are explaining it to people and no one understands WTF they are talking about then whats the point.?

Most professions use their own language which is beyond the comprehension of most people.

[Neuro]

Seems like your brother fell on his side and broke his hip as picture shows:

http://www.maitrise-orthop.com/corpusmaitri/orthopaedic/mo65_trochanteric_fracture/evans1bis.jpeg

This is a common fracture in older patients with Osteoporosis, which means the bone is getting porous...

Impacted just means the bone fragments was pressed in or wedged together under impact, it doesn't have anything to do with time frame...

[Cebu_4_2]

I know it's no help but this is what I found:

trochanter

[troh-kan-ter] http://sp.dictionary.com/dictstatic/g/d/dictionary_questionbutton_default.gif (http://dictionary.reference.com/help/luna/Spell_pron_key.html) http://sp.dictionary.com/dictstatic/g/d/speaker.gif (http://dictionary.reference.com/audio.html/lunaWAV/T05/T0520800) 
Greater Trochanter
Learn Causes, Symptoms, Treatment and Prevention on Any Health Issue.
www.everydayhealth.com
(http://www.google.com/aclk?sa=l&ai=C0rJXfDMET6GWF4e-gwfu0JCOB7aLyIEC3sCP7hy4056wBBABIIfV9xhQz-CCwQNgyd6yiZCk6A-gAbz4l-wDyAEBqgQfT9B9PIA83LAb4D8I5FIkFRj3a1wfhaF9XAuH2WYQ ZQ&num=1&sig=AOD64_3dPY5oRDg5OLXrDAC7PizQ-fLy2g&adurl=http://www.everydayhealth.com/info/v1/greater%2520trochanter%3Fs_kwcid%3DTC%7C21765%7Cgr eater%2520trochanter%7C%7CS%7Cb%7C7650435734) Dictionary.com Free Toolbar
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tro·chan·ter

  http://sp.dictionary.com/dictstatic/g/d/speaker.gif (http://dictionary.reference.com/audio.html/lunaWAV/T05/T0520800) [troh-kan-ter] http://sp.dictionary.com/dictstatic/g/d/dictionary_questionbutton_default.gif (http://dictionary.reference.com/help/luna/Spell_pron_key.html)
noun 1.Anatomy. either of two knobs at the top of the femur, the greater on the outside and the lesser on the inside, serving for the attachment of muscles between the thigh and pelvis.

2.Zoology. any similar prominence on the femur in many other vertebrates.

3.Entomology. (in an insect) the usually small second segment of the leg, between the coxa and femur.




Origin:
1605–15; < Neo-Latin < Greek trochantḗr ball on which the hip bone turns in its socket

[Serpo]

Instead of saying hes got a broken hip..................

[mamboni]

Seems like your brother fell on his side and broke his hip as picture shows:

http://www.maitrise-orthop.com/corpusmaitri/orthopaedic/mo65_trochanteric_fracture/evans1bis.jpeg

This is a common fracture in older patients with Osteoporosis, which means the bone is getting porous...

Impacted just means the bone fragments was pressed in or wedged together under impact, it doesn't have anything to do with time frame...



I concur doctor. The description of the fracture is highly technical because it determines the exact procedure that will be performed by the orthopedic surgeon. Hip fractures usually occur before the patient falls, though the chronology suggests the opposite.

BTW, osteoporosis/osteopenia is rampant here in America. Everyone should be supplementing with 5000 IU vitamin D3 per day, especially the ladies.

[muffin]

BTW, osteoporosis/osteopenia is rampant here in America. Everyone should be supplementing with 5000 IU vitamin D3 per day, especially the ladies.
I was told a while back that it's best to take that in in your early 20s to early 30s. After that, you body doesn't absorb it.....

So I tried packing in as much as I could back then. I don't bother with any vitamins now.

Ihatepills

[mamboni]

I was told a while back that it's best to take that in in your early 20s to early 30s. After that, you body doesn't absorb it.....

So I tried packing in as much as I could back then. I don't bother with any vitamins now.

Ihatepills


Get the Vitamin D3 in capsules - it is well absorbed even after age 30!

[DMac]

Get the Vitamin D3 in capsules - it is well absorbed even after age 30!

Or liquid drops, similar to these:
http://www.vitacost.com/Vitacost-Vitamin-D-Drops

Me and my GF take 4-6000iu/day with OJ in the morning along with the Oil of Oregano.

[muffin]

Oil of Oregano.
OH GOOD LORD! How do you even get that past your tongue??

[DMac]

OH GOOD LORD! How do you even get that past your tongue??

I put the drops in OJ. After using it for a while the taste isn't so strong. My gf used to gag with it at first now she craves it as much as I do.

That stuff is the nectar of the gods! Truly a super food/supplement with dozens of uses.

edit - chug the OJ/water. Not for sipping. :)

[muffin]

edit - chug the OJ/water. Not for sipping. :)

Yeah, I learned that the first time ;) I guess I could try doing it again. But it's so damn disgusting. My throat immediately closes up in protest as soon as it hits my tastebuds....

[beefsteak]

I concur doctor. The description of the fracture is highly technical because it determines the exact procedure that will be performed by the orthopedic surgeon. Hip fractures usually occur before the patient falls, though the chronology suggests the opposite.

BTW, osteoporosis/osteopenia is rampant here in America. Everyone should be supplementing with 5000 IU vitamin D3 per day, especially the ladies.

Thank you, gentlemen.

I'd like to follow-up with what your "timing" comment has led me to discover, Mamboni.

Based upon your "fractures usually occur before the patient falls," I've learned of an earlier fall in September after release from the State mandated care after involuntary commitment for 30 days at a state facility after he was found driving wrong way down an interstate 30 miles from his home.

He was released to a residential care facility, and while there, twisted an ankle and fell. The TWIT sister-in-law removed him AMA from the facility, but never sought medical examination.

Again, I'm asking, is there any way "old fractures" or even the potential for old fractures could result in the "impacted part" of the diagnosis, i.e., post 90 days ago fall fragments could already have been healing, aka show up Saturday last as "impacted" when in fact, they were 90 day plus self-mending presentations instead of new damage?

Thanks again for your response, gentlemen.

Not only did this twit of a SIL I'm learning not take him for post fall eval, but she also cold turkey removed him from Dr ordered BP meds while he was at the facility. It is not known at this juncture if he was "white coat BP" or truly had an underlying BP problem, say due to his 2 unoperated upon groin hernias, also observed and measured by CAT on Sat last.

Now, you can perhaps understand why we are seeking additional musings from you two gentlemen.

Again, my thanks.

We fully understand that we all die. We just don't have to put up with some twit SIL greasing his slippery slope, you know?


beefsteak

[Neuro]

Beefsteak, a 90 day old fracture would have healed completely in about half that time, even without any surgical treatment sure it could have some radio-opaque areas at the old fracture line, which indicates calcifications at those areas, but it would be practically impossible to fracture that again, since the healed bone is far stronger than the surrounding bone. Leaving only the possibility of an old fracture healed in 2 pieces, but that would appear totally different on a x-ray. For instance the bone pieces would not be in its normal position, as the x-ray report stated (cause if they had been the fracture segments would have healed together. I doubt a radiologist would miss something like that.

With more than 99% likelihood your brother had a new fracture...

[Luis337]

I tried 2,400 IU's of Vitamin D one day. I felt really happy. Is there a certain number of IU's where an overdose is possible?

[DMac]

I tried 2,400 IU's of Vitamin D one day. I felt really happy. Is there a certain number of IU's where an overdose is possible?

You need to take a ton of D for it to get toxic:

http://www.vitamindcouncil.org/about-vitamin-d/what-is-vitamin-d/vitamin-d-toxicity/


Toxic doses

What exactly constitutes a toxic dose of vitamin D has yet to be determined, though it is possible this amount may vary with the individual.

Published cases of toxicity, for which serum levels and dose are known, all involve intake of ≥ 40000 IU (1000 mcg) per day. 1 Two different cases involved intake of over 2,000,000 IU per day - both men survived. 2 3

[Luis337]

thanks DMac, 2 million is definitely a lot.

[DMac]

thanks DMac, 2 million is definitely a lot.

No problem. A long day at the beach with no shower will likely lead to about 10-20,000IU absorption through the skin. I use that as a baseline for "too much". We never pass 12k/day when sick in my house and try to get 4-6k per day unless memory slips.

:)

[Joe King]

I tried 2,400 IU's of Vitamin D one day. I felt really happy.

This happy?



http://www.youtube.com/watch?v=PuAOMjze09g

[Dvrumo]

Beefsteak, a 90 day old fracture would have healed completely in about half that time, even without any surgical treatment sure it could have some radio-opaque areas at the old fracture line, which indicates calcifications at those areas, but it would be practically impossible to fracture that again, since the healed bone is far stronger than the surrounding bone. Leaving only the possibility of an old fracture healed in 2 pieces, but that would appear totally different on a x-ray. For instance the bone pieces would not be in its normal position, as the x-ray report stated (cause if they had been the fracture segments would have healed together. I doubt a radiologist would miss something like that.

With more than 99% likelihood your brother had a new fracture...

I agree in a normal healthy person, a fracture should show significant healing response at the 90 day mark. However, in an elderly person with other co-morbidities (osteoporosis, nutritional status?) the response can be very difficult to appreciate and radiographically occult. I agree with the underlying thought however, that it is likley a new fracture.