Orthogeriatrics

Orthogeriatrics is a specialist approach to caring for older patients with fractures and orthopaedic injuries, especially where there are additional medical needs such as frailty, osteoporosis, multiple long-term conditions, memory problems, or a higher risk of complications during recovery.

The aim is to support safer surgery (when required), smoother recovery, and better long-term function by combining orthopaedic care with expert medical management and rehabilitation planning.

At the Royal Buckinghamshire Hospital, orthogeriatric-style care focuses on whole-person recovery, helping patients regain mobility and independence while reducing the risks that can follow injury and hospital treatment.

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What Orthogeriatrics Covers

Orthogeriatrics typically involves coordinated care across:

• Fracture and trauma recovery (particularly hip fractures and complex fragility fractures)
• Frailty assessment and optimisation
• Medication review (reducing side effects, falls risk, delirium risk)
• Delirium and dementia-aware care
• Osteoporosis assessment and fracture prevention
• Pain control that supports mobility and safety
• Nutrition and hydration support
• Rehabilitation planning (physiotherapy/OT and discharge planning)
• Reducing complications such as infections, clots, pressure sores, and deconditioning

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Who Orthogeriatrics is for

Orthogeriatric care is often most helpful for patients who:

• Are older or frail
• Have had a fragility fracture (a fracture after a low-level fall)
• Have multiple medical conditions (e.g., heart disease, diabetes, COPD)
• Take multiple medications
• Have reduced mobility or are at high risk of falls
• Have memory problems or are at risk of delirium
• Have osteoporosis or suspected bone fragility

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Common Reasons for Orthogeriatric Assessment

Orthogeriatric input may be recommended where there is an increased risk of complications or slower recovery, for example:

• Hip fracture or major lower-limb fracture
• Wrist, shoulder, pelvis, or spinal compression fractures related to bone fragility
• Recurrent falls or reduced balance
• Post-operative confusion, drowsiness, or fluctuating alertness
• Poor nutritional intake, dehydration, or weight loss
• Complex discharge needs or concerns about coping at home

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Symptoms and Issues Orthogeriatrics Helps With

Orthogeriatrics doesn’t treat one symptom in isolation — it supports recovery by addressing the broader factors that affect healing. These may include:

• Pain limiting movement or rehabilitation progress
• Dizziness, low blood pressure, or medication side effects
• Low confidence walking, fear of falling, or reduced strength
• Confusion, delirium, agitation, or memory decline during illness
• Poor sleep, fatigue, or low mood affecting recovery
• Poor appetite, weight loss, or dehydration
• Recurrent falls or unsteadiness
• Concerns around bone health and future fracture prevention

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Assessment at Royal Buckinghamshire Hospital

An orthogeriatric-style assessment typically includes:

• Review of your injury and current mobility
• Review of medical history and long-term conditions
• Medication review (including falls risk and interactions)
• Assessment for frailty, delirium risk, and cognitive concerns
• Pain management review to support safe movement
• Hydration, nutrition, and anaemia screening where appropriate
• Bone health assessment (osteoporosis risk and prevention plan)
• Rehabilitation and discharge planning in coordination with therapy teams

You will receive a clear plan focused on safe recovery and returning to the best possible level of independence.

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Treatment & Management

Your care plan may include:

Optimising medical health during recovery

• Managing heart, lung, kidney, or metabolic conditions during rehabilitation
• Preventing and treating post-operative or post-injury complications
• Monitoring and managing infection risk, clot risk, and pressure area care

Pain control that supports rehabilitation

• A balanced pain plan to reduce pain while avoiding excessive drowsiness
• Reviewing medications that may worsen confusion or falls risk

Mobility and independence support

• Physiotherapy to rebuild strength, balance, and walking ability
• Occupational therapy for daily activities, equipment, and home safety planning

Delirium prevention and cognitive support

• Identifying triggers (infection, dehydration, medication effects)
• Supporting routine, sleep, orientation, and family involvement where relevant

Bone health and fracture prevention

• Osteoporosis assessment and treatment planning where appropriate
• Falls risk assessment and prevention advice
• Vitamin D/calcium advice where relevant, plus onward referral if needed

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When to seek urgent help

Seek urgent medical advice if, during recovery from a fracture or surgery, there is:

• Sudden worsening confusion, drowsiness, or agitation
• New weakness, inability to walk, or repeated falls
• Chest pain, breathlessness, or calf swelling
• Fever, increasing pain, redness, or wound leakage (if post-operative)
• New loss of bladder or bowel control

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If you are recovering from a fracture, have recurrent falls, or need coordinated support due to frailty or complex medical needs, contact Royal Buckinghamshire Hospital to discuss an assessment and recovery plan. There is no need to be registered with the hospital, or live locally.

If you have insurance which covers consultations, we can in most cases invoice the insurer directly. Where you are paying directly, any costs will always be discussed.