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SpecialtyGeriatric orthopaedics & age management
The ageing skeleton deserves specialist thinking, not smaller doses of adult orthopaedics. From the emergency of a fragility hip fracture to the long game of keeping muscle, bone and balance - this is care for the years that matter most.
Fragility hip fractures - the true emergency
A hip fracture in an elderly person is a medical emergency wearing an orthopaedic disguise: the danger is not the broken bone but the bed rest it enforces. The evidence is unambiguous - surgery within 24-48 hours, followed by standing the patient up fast, is what protects life. This practice treats that timeline as a protocol, not an aspiration, with fixation or replacement chosen by fracture pattern and bone quality.
Osteoporosis and bone health
Every fragility fracture is investigated for the disease behind it. Bone density assessment, correction of vitamin D and calcium, and modern bone-protecting medication where indicated - because fixing the fracture while ignoring the bone guarantees a sequel.
Joint replacement in the elderly
Age is a number; fitness is a finding. Elderly patients crippled by arthritis are assessed on cardiac, pulmonary and cognitive grounds - and when fit, they are among the most grateful beneficiaries of replacement surgery, trading a shrinking painful world for restored independence.
Falls prevention
The fracture is the last event in a chain: sedating medicines, failing vision, weak legs, a loose rug. Each link is correctable. Families receive a structured falls-prevention review alongside the orthopaedic treatment - preventing the next fracture is part of treating this one.
Age management - the proactive discipline
As a Life Member of the Indian Association of Age Management (IAAM - LM0071), Dr. Srivastava practises the forward-looking half of geriatric care: preserving muscle (sarcopenia screening), bone, balance and mobility before the fall - through assessment, targeted exercise prescription, nutrition and treatment. The goal is not longevity alone; it is mobility for the whole of it.
My 80-year-old parent has broken their hip. Is surgery safe at this age?
In most cases surgery is not only safe but the safer option - modern evidence strongly favours operating on fragility hip fractures early, ideally within 24-48 hours, because prolonged bed rest is what kills. Age alone is almost never the barrier; untreated immobility is.
Is joint replacement possible in the very elderly?
Yes - fitness, not age, decides. A well-selected 85-year-old can gain years of independent, pain-free mobility from a replacement. The assessment is medical: heart, lungs, cognition and home support, evaluated honestly.
What is age management in the orthopaedic context?
It is the proactive side of geriatric care: protecting muscle mass (sarcopenia), bone density, balance and mobility before the fracture or the fall - through assessment, targeted exercise, nutrition and bone-protecting treatment where indicated. Dr. Srivastava is a Life Member of the Indian Association of Age Management (IAAM).
After one fragility fracture, what next?
The first fragility fracture is a warning shot: without treatment, the risk of the next one rises steeply. Every such patient here is assessed for osteoporosis and started on a bone-health plan - treating the fracture without treating the bone is half the job.
How can falls be prevented in an elderly parent?
Systematically: review medicines that cause drowsiness or drops in blood pressure, correct vision, strengthen legs and balance with simple daily exercises, and de-trap the home - loose rugs, dark corridors, wet bathrooms. Most falls are preventable events, not accidents.
Mobility for the years that matter
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