Hemiarthroplasty in a patient with severe systemic sclerosis

Area of Science:

• Rheumatology
• Orthopedic Surgery
• Dermatology

Background:

• Systemic sclerosis (scleroderma) is a rare, chronic, multisystem connective tissue disorder of unknown origin.
• Characterized by skin thickening and microstructural changes, it poses significant challenges in surgical settings.
• Limited literature exists on orthopedic surgical outcomes, particularly hip procedures, for patients with scleroderma.

Observation:

• A case report of a 74-year-old male with a history of scleroderma undergoing bipolar hemiarthroplasty for a right transcervical femoral neck fracture.
• The patient's scleroderma presented risks related to wound healing and skin contractures.
• A review of orthopedic literature revealed no prior reports on surgical outcomes or skin closure success in hip procedures for scleroderma patients.

Findings:

• Scleroderma-related skin changes can lead to numerous surgical complications.
• Wound healing and skin contractures are critical risk factors in scleroderma patients undergoing orthopedic surgery.
• This case underscores the lack of specific data on hip surgery outcomes in this patient population.

Implications:

• Highlights the need for careful preoperative assessment and management of skin integrity in scleroderma patients.
• Suggests a need for further research into optimal surgical techniques and wound closure strategies for hip procedures in scleroderma patients.
• Emphasizes the importance of considering systemic sclerosis as a significant factor influencing orthopedic surgical outcomes.