Hip fractures a growing public health concern

WE were saddened by the news that former Prime Minister Tun Dr Mahathir Mohamad recently suffered a hip fracture after a fall. As a group of healthcare professionals who care for those with hip fractures every day, we can appreciate firsthand the impact this injury can have on patients and their families.

While the news about Dr Mahathir’s injury has understandably drawn much public attention, it also serves as a timely reminder that hip fractures are a growing and serious public health problem in Malaysia.

Across Asia, the number of hip fractures is rising rapidly. Projections from the Asian Federation of Osteoporosis Societies (AFOS) indicate that Malaysia is expected to experience one of the highest rates of increase in hip fracture numbers over the coming decade. This is driven by our growing ageing population.

Hip fractures are not simply broken bones. They are often life-changing events for the person and their families. For many older people, they mark a sudden loss of independence, disability and ill health. Many who sustain a hip fracture require prolonged recovery, and some do not return to their previous level of function. This places growing pressure on hospital beds, rehabilitation services and long-term care.

The good news is that hip fractures can be managed well when care is delivered in a timely, coordinated and patient-centred manner. Malaysia took an important step on this matter with the publication of the clinical practice guideline (CPG) on hip fracture management in 2023, bringing together best-practice recommendations developed by local experts and informed by international evidence.

At the heart of the CPG is the principle of personalised multidisciplinary care. Optimal recovery requires more than just fixing the fractured hip. Orthopaedic surgeons manage the fracture while physicians address co-existing medical problems. Nurses provide essential care and comfort, therapists support rehabilitation and functional recovery, dietitians optimise nutrition, and pharmacists ensure safe and appropriate use of medication.

Importantly, the team also work to reduce future falls risk and improve bone health to prevent further fractures.

This coordinated approach, often delivered through orthogeriatric and fracture liaison services, has been shown to improve outcomes and support better hip fracture recovery.

For us at the Fragility Fracture Network Malaysia, we are encouraged to see these services being established across government hospitals, university hospitals and the private sector.

However, there is still much to do. Continued support and expansion of these models of care from policymakers and stakeholders will be crucial as Malaysia prepares for the challenges of an ageing population.

We extend our sincere wishes to Dr Mahathir for a full and speedy recovery.

DR TERENCE ONG

Assoc professor and consultant geriatrician

On behalf of the Fragility Fracture Network Malaysia