A green channel was opened and multidisciplinary cooperation was carried out, and an elderly patient with comminuted fracture around the prosthesis was successfully treated in Guanghua Hospital a few days ago.
My wife fell at home, and 73-year-old Grandma Zhang hurriedly went to help, but she didn't expect to step on the wet ground and fall down, resulting in a comminuted fracture of the lower femur.
What's even more unfortunate is that Grandma Zhang's right knee had just undergone knee joint surface replacement in Guanghua Hospital more than 1 year ago, and the postoperative function has been very good.
"After a periprosthetic fracture, if there is loosening of the prosthesis, revision of the joint is required. If the prosthesis is stable, fracture reduction and fixation are required, because there is a prosthesis, and there are more confounding factors to consider in the reduction and fixation of periprosthesis fractures than general fractures. However, periprosthetic fractures in the elderly are highly complicational and disabling, and even fatal. Gao Huali, deputy chief physician of the Department of Joint Orthopedics of Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, introduced.
What worries the doctor even more is that after being sent to the hospital, Grandma Zhang's deep vein thrombosis has formed. If the "bomb" of deep vein thrombosis is not ruled out, pulmonary embolism is very likely to occur after the thrombus falls off, and mild cases will cause symptoms such as chest tightness, shortness of breath, chest pain, etc., and severe pulmonary embolism will lead to fainting, coma, and even dyspnea leading to life-threatening and death.
"If a pulmonary embolism occurs during surgery, the consequences are unimaginable." According to the actual situation of the patient, Sun Zhonghua, director of the Department of Cardiology, quickly placed an inferior vena cava filter for Grandma Zhang to intercept thrombosis, prevent pulmonary embolism, and "sweep mines" for orthopedic surgery.
After that, Dr. Gao Huali's team performed open reduction and internal fixation of the right femoral periprosthetic fracture for Grandma Zhang, and Grandma Zhang was sent to the ICU for close monitoring to prevent the occurrence of various emergencies after the operation, and then transferred to the general ward, where she is currently recovering well.
Coincidentally, in the same week, Guanghua Hospital also admitted an elderly patient with a hip periprosthetic fracture that caused the prosthesis to loosen, and was also accompanied by deep vein thrombosis.
To this end, Dr. Gao Huali reminded that to prevent periprosthetic fractures, reasonable anti-osteoporosis treatment should be carried out, and calcium supplements, more sunlight, more milk and soy products can be eaten; It is necessary to carry out scientific and effective functional exercises, strengthen muscle strength and functional exercises, and maintain muscle coordination and limb flexibility; It is necessary to actively treat the underlying diseases, strengthen nursing, and prevent falls.
Some of the pictures are from the Internet Writing: Zhao Li, Xiang Xinran (intern)
Editor: Li Bingqian
Editor-in-charge: Yan Wenbin
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