We experienced anesthetic management of open reduction for a femoral neck fracture in a patient com- plicated with fat embolism syndrome. An 83-year-old woman with a femoral neck fracture was admitted to our hospital after suffering an injury. She developed hypoxemia on admission. Chest X-ray showed a decrease in permeability of the right lung and chest CT scan showed ground glass opacities of the right lung. A blood test showed anemia, thrombocytopenia, and elevation of C-reactive protein. She was diagnosed with fat embolism syndrome using the classification of Tsuruta. Oxygen was administered. C-reactive protein decreased gradually after hospitalization. Echocardiog- raphy showed normal left ventricular function without pulmonary hypertension. She was scheduled for open reduction for the femoral neck fractu-e with artificial grit insertion under general anesthesia 6 days after hospitalization. Her operation was performed with- out exacerbation of the fat embolism syndrome. She was extubated in the operating room, and was dis- charged from the recovery room without any conpli- cations. After surgery, chest X-ray showed further improvement and she was transferred to a rehabilita- tion hospital on the 27th hospital day.
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A A Pract
January 2025
From the Department of Anesthesiology, Sheba Medical Center, Ramat Gan, Israel.
This case series reviews surgeries involving elderly patients with femoral neck fractures on apixaban who underwent spinal anesthesia (SA) within 72 hours of their last dose. Despite patients being on anticoagulation, no neurological complications occurred, suggesting SA may be practical in cases where the benefits of timely surgery outweigh the potential risks, including apixaban discontinuation for a period of less than the recommended 72 hours with detectable levels of the drug remaining in the plasma. Quantitative apixaban measurements offered useful anticoagulation status insights, though safe thresholds remain undefined.
View Article and Find Full Text PDFSAGE Open Med
January 2025
ESIC Medical College and Hospital and Occupational Disease Center [East Zone], Joka, Kolkata, India.
Background: Despite multiple studies, less recent literature and data regarding the mortality associated with hip fractures in the elderly population are available.
Objectives: To assess the mortality data and functional outcomes of patients who underwent cemented and uncemented hemiarthroplasty in femoral neck fractures. To evaluate if preoperative (minimum 2 months) calcium and vitamin D supplement intake in patients affects postoperative mobilization with or without walker support.
BMC Musculoskelet Disord
January 2025
Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, 2001 Vail Ave, Charlotte, NC, USA.
Background: Hip morphology variations, particularly in femoral neck shaft angle (NSA) and iliac wing width (IWW), have been associated with gluteal tendinopathy. However, the biomechanical implications of these morphological differences on gluteal muscle function are not well understood. This study investigates how NSA and IWW influence gluteal muscle forces, moment arms, and estimated tendon loads during walking, aiming to provide insights into the potential biomechanical pathways that may contribute to altered lateral hip loading patterns.
View Article and Find Full Text PDFBone Jt Open
January 2025
Division of Trauma & Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
Aims: The primary aim of this study is to compare mobility status of patients receiving oral oxycodone with those receiving subcutaneous alfentanil as analgesic methods prior to mobilization to help physiotherapy compliance after hip fracture surgery. The secondary aims are to assess postoperative pain, health-related quality of life, in-hospital length of stay, total use of analgesia over postoperative days 1 and 2 (POD 1 and POD 2), complication rates within 30 days, and 30-day mortality rates.
Methods: A single-centre, prospective cohort study of 64 patients will be undertaken.
Clin Orthop Relat Res
December 2024
Naval Medical Center San Diego, San Diego, CA, USA.
Background: Femoroacetabular impingement (FAI) is a well-recognized cause of hip pain in adults. The hip-spine relationship between the femur, pelvis, and lumbosacral spine has garnered recent attention in hip arthroplasty. However, the hip-spine relationship has not been well described in patients with FAI.
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