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Case Report: 100-year-old COVID-positive Hip Fracture Patient for Hemiarthroplasty Under Spinal Anesthesia
Jonathan C Beathe1,2, Stavros G Memtsoudis1,2,3
1Hospital for Special Surgery, New York, NY, USA.
Insights
This case study highlights the successful management of a 100-year-old hip fracture patient who also had novel coronavirus disease 2019 (COVID-19). Favorable outcomes were achieved through a combination of regional anesthesia, early surgery, and hydroxychloroquine therapy.
Area of Science:
- Geriatric surgery
- Infectious disease management
- Anesthesiology
Background:
- Elderly patients with hip fractures present significant perioperative risks.
- The COVID-19 pandemic introduced novel challenges to managing these patients.
- Optimal perioperative strategies are crucial for this vulnerable population.
Observation:
- A 100-year-old patient with a hip fracture tested positive for COVID-19.
- The patient underwent hemiarthroplasty under spinal anesthesia.
- Hydroxychloroquine (HCQ) therapy was administered post-surgery.
Findings:
- The patient experienced a favorable outcome despite advanced age and COVID-19 infection.
- Key contributing factors included preoperative assessment, early surgical intervention, and regional anesthesia.
- Early mobilization and HCQ therapy may have played a role in the positive result.
Implications:
- This case demonstrates the feasibility of managing elderly hip fracture patients with COVID-19.
- Multifactorial perioperative care, including specific anesthetic and therapeutic choices, can lead to success.
- Further research into optimizing care for COVID-19 positive surgical patients is warranted.
Abstract:
Elderly patients undergoing hip fracture surgery represent a myriad of perioperative challenges and risks. The arrival of the global pandemic of novel coronavirus disease 2019 (COVID-19) adds an unprecedented challenge to the management of hip fracture patients. We describe the unique experience and favorable outcome of a 100-year-old COVID-positive hip fracture patient that underwent spinal anesthesia for hemiarthroplasty and subsequent hydroxychloroquine (HCQ) therapy. Multiple factors of varying known benefit may have contributed to our outcome, including preoperative medical consultation and assessment, early surgical intervention, regional anesthesia with little to no sedation, early mobilization and HCQ therapy.
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