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保守治疗的股骨粗隆间骨折合并早期无症状新型冠状病毒肺炎(COVID-19):一例报告

Conservatively Treated Femoral Intertrochanteric Fracture With Early Asymptomatic Novel Coronavirus Disease 2019 (COVID-19): A Case Report.

作者信息

Suzuki Yuki, Kasashima Toshihiko, Hontani Kazutoshi, Yamamoto Yasuhiro, Ito Kanako, Xu Liang, Matsuoka Masatake, Iwasaki Koji, Onodera Tomohiro, Kondo Eiji, Iwasaki Norimasa

机构信息

Department of Orthopaedic Surgery, Sapporo-Kosei General Hospital, Sapporo, Hokkaido, Japan.

Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.

出版信息

Geriatr Orthop Surg Rehabil. 2020 Oct 28;11:2151459320969380. doi: 10.1177/2151459320969380. eCollection 2020.

Abstract

INTRODUCTION

The ongoing outbreak of novel coronavirus disease 2019 (COVID-19) is a worldwide problem. Although diagnosing COVID-19 in fracture patients is important for selecting treatment, diagnosing early asymptomatic COVID-19 is difficult. We describe herein a rare case of femoral intertrochanteric fracture concomitant with early asymptomatic novel COVID-19.

CASE PRESENTATION

An 87-year-old Japanese woman was transferred to our emergency room with a right hip pain after she fell. She had no fever, fatigue, or respiratory symptoms on admission and within the 14 days before presenting to our hospital, and no specific shadow was detected in chest X-ray. However, chest computed tomography (CT) was performed considering COVID-19 pandemic, and showed ground-glass opacities with consolidation in the dorsal segment of the right lower lung field. Then, qualitative real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) was carried out and turned out to be positive. She was diagnosed right femoral intertrochanteric fracture with concomitant COVID-19 infection. Conservative treatment was applied to the fracture due to infection. After admission, fever and oxygen demand occurred but she recovered from COVID-19. Throughout the treatment period, no cross-infection from the patient was identified in our hospital.

CONCLUSION

This case highlights the importance of considering chest CT as an effective screening method for infection on hospital admission in COVID-19-affected areas, especially in trauma patients with early asymptomatic novel COVID-19.

摘要

引言

2019年新型冠状病毒病(COVID-19)的持续爆发是一个全球性问题。虽然在骨折患者中诊断COVID-19对于选择治疗方法很重要,但早期无症状COVID-19的诊断却很困难。我们在此描述一例罕见的股骨转子间骨折合并早期无症状新型COVID-19病例。

病例介绍

一名87岁的日本女性在跌倒后因右髋部疼痛被送往我们的急诊室。入院时及在我院就诊前的14天内,她没有发热、乏力或呼吸道症状,胸部X光检查未发现特异性阴影。然而,考虑到COVID-19大流行,进行了胸部计算机断层扫描(CT),显示右下肺野背段有磨玻璃影并伴有实变。随后,进行了定性实时逆转录聚合酶链反应(RT-PCR),结果呈阳性。她被诊断为右股骨转子间骨折合并COVID-19感染。由于感染,对骨折采取了保守治疗。入院后,患者出现发热和吸氧需求,但她从COVID-19中康复。在整个治疗期间,我院未发现该患者有交叉感染情况。

结论

该病例凸显了在COVID-19感染地区,尤其是早期无症状新型COVID-19的创伤患者入院时,将胸部CT作为一种有效的感染筛查方法的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ed5/7597567/262dd7aebfce/10.1177_2151459320969380-fig1.jpg

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