Managing the surgical orthopaedic patient with Parkinson's disease

Parkinson's disease is a chronic, progressive, disabling, neurologic disorder that can complicate the diagnosis, clinical course, and recovery from comorbid conditions, such as traumatic fractures. Attention to specific aspects of management ought to minimize morbidity and facilitate orthopaedic recovery, notably medication titration and airway protection, hemodynamic stability, and surveillance proportional to mental capacity. Classical orthopaedic management may have to be altered, especially if the patient has advanced neurologic disease. Optimal management of patients with combined surgical orthopaedic and neurologic disease offers the treatment team an unusual opportunity to collaborate and coordinate multiple facets of care.