In the evening of April 16, 2009, the orthopedic department of Xuanwu Hospital admitted an unusual patient, a 100-year-old grandmother, to the emergency department.
This 100-year-old grandmother was walking in the yard when she failed to stand up and fell down. A normal fall may not be a big deal for us young people or middle-aged people, but it is different for the elderly, many elderly patients have different degrees of osteoporosis, and if combined with some underlying pathologies, the consequences of this fall may be fatal. At that time, the grandmother could not move, and the intense and continuous pain tormented the old man with sweat beads falling down. After arriving at the emergency room, the doctor was very experienced and took medical history, physical examination, and films, and the diagnosis of right femoral neck fracture was clear. Shen Huiliang, Department of Orthopedics, Xuanwu Hospital, Capital Medical University
It is reasonable to admit such a patient with a clear diagnosis and a clear indication for surgery, he should be operated early without hesitation. Are there any underlying diseases? Can the elderly successfully survive the high risk of the perioperative period? Will complications such as lower limb venous thrombosis and pneumonia caused by prolonged bed rest be devastating to the elderly? Although she is over 100 years old, she is hale and hearty, and she can climb two flights of stairs without panting, and she has no coronary heart disease, diabetes or hypertension. However, not only the family members but also some doctors have some concerns and worries about whether such a 100-year-old can safely survive the perioperative period. Should we operate or not? Can we do this surgery?
After discussion and research by orthopedic surgeons at all levels, the patient’s physical condition before the injury made it necessary to do this surgery! Fractures of the femoral neck are extremely slow to heal, taking at least six months, and are prone to femoral head necrosis. The prerequisite for fracture healing is braking of the affected limb. However, prolonged bed rest can lead to fatal complications such as pneumonia, blood clots and bed sores, not to mention a 100 year old man. Considering the grandmother’s positive attitude towards life, getting her on her feet as soon as possible is the core objective of treatment. Arthroplasty was undoubtedly the only way.
So, the whole department worked together, collaborated with the cardiology department, improved the preoperative examination, evaluated the cardiac function and tolerance of the operation, and with the full cooperation of the anesthesia department and the operating room, the orthopedic surgeons successfully completed the right hemiarthroplasty for the elderly after careful preparation and meticulous operation. The patient had little bleeding during the operation and returned to the vascular surgery ward after the operation. Director Shen gave special instructions: we must take good care of the patient and let him walk out of the hospital in good health!
On the night of surgery, the patient, whose vital signs were stable, was once drowsy, and all medical and nursing staff in the guardianship room entered a state of first-grade alert, pumping blood gas, checking electrolytes, administering oxygen, rehydrating …… various rescue measures were carried out in an orderly manner, finally, with everyone’s efforts, the patient successfully passed the dangerous period and was operated on the The next day, the patient was safely transferred out of the vascular surgery ward and transferred to the general ward to continue treatment. On the fifth day after the operation, the patient was able to walk on his own with the help of crutches. The old man and his family even said that the medical staff of our department gave the old man a second chance to live a positive and optimistic life.
Through the treatment of this 100-year-old man, we can proudly say that Xuanwu Orthopedics stands at the top of the heap in the diagnosis and treatment of orthopedic diseases in the elderly! We are confident and more capable to undertake the rescue and treatment of various diseases, to build our department, to make it even better, and to provide quality medical services to more patients.