Nancy Reagan in Hospital After Fall

Oct. 15, 2008 -- Former first lady Nancy Reagan is hospitalized in Los Angeles due to a fracture in her pelvis and sacrum.

"Reagan fell at her home last week in Los Angeles. After experiencing persistent pain, Mrs. Reagan admitted herself to the Ronald Reagan UCLA Medical Center for tests which revealed a fractured pelvis and sacrum," read Wednesday's statement from Joanne Drake, spokesperson for Nancy Reagan.

According to Drake, Reagan, 87, will remain at UCLA for the next few days and will then return home once doctors are satisfied with her progress.

The type of fracture experienced by Reagan is not uncommon among elderly women with osteoporosis, orthopedic experts said. A fracture of the pelvis bone occurs most frequently when a patient breaks a fall with the buttocks, though this fracture can also occur in osteoporosis patients randomly during any activity.

It has not been confirmed whether Reagan has osteoporosis, but the condition, which causes diminished bone density, is common in older women after menopause.

Dr. Andrew Freiberg, vice chairman of the Department of Orthopaedic Surgery at the Massachusetts General Hospital in Boston, said he expects Reagan to experience a full and uncomplicated recovery within the next six to eight weeks.

"This is probably a fracture from osteoporosis, and it'll cause her some pain for a couple weeks, but should very likely heal uneventfully," Freiberg explained.

The good news about this fracture, Freiberg explained, is that it very rarely requires surgery for the bones to heal properly.

Dr. Charles Cornell, orthopedic trauma surgeon at the Hospital for Special Surgery in New York, explained that Reagan's recovery will probably consist of a short two-week period of immobilization, followed by about four to six weeks of physical therapy.

"I think absolutely she will require assistance at home probably initially around the clock," Cornell explained. "She'll need people to help her move from bed to bathroom and people to prepare meals for her and help her get dressed, and she will be fairly disabled early on for two to three weeks, but she should start feeling better after that and her function will return."

Reagan's Hip Fracture to Require Bed Rest

However, one major concern many orthopedic experts have regarding this type of injury in the elderly is that bed rest, though required for the fracture to heal, might do even more harm than good.

"The biggest complication for this type of fracture in an elderly patient is that they become immobilized and are in a situation where they're stuck in bed and it's difficult to get [them] up and moving," said Dr. Aaron Rosenberg, professor of surgery at the Rush Medical College in Chicago.

Rosenberg explained that immobilization over an extended period of time often leads to muscle atrophy in the elderly, or the tightening up of the muscles and joints. Extended bed rest can also lead to bed sores or even blood clots, he said.

"One of risks of being bedridden for several weeks is muscle atrophy," Rosenberg said. "One of things physical therapy does is that even though the patient can't walk, they can move joints and strengthen muscles."

Still, experts don't expect that Reagan will be immobilized for longer than about two to three weeks.

After the first two to three weeks of relative immobilization, Cornell said that Reagan will begin working with a physical therapist at home to increase her mobility. He noted that Reagan will require a walker to ease the amount of pressure on her fractured pelvis, and will most likely be prescribed mild pain medication that should allow her more freedom to move around without pain.

"For about three weeks, the pain is pretty bad so [she will probably be] limited to household ambulation, walking only short distances with a walker," Cornell said. "Then, once she starts to feel better, the therapist will work on restorative exercises to overcome any atrophy that might have set in from this period of inactivity."

Overall, however, experts agree that Reagan's prognosis is very good and she should be back to her old self in a matter of a couple of months.