Geriatric Medicine, Changi General Hospital, Singapore
Geriatric Medicine, Changi General Hospital, Singapore.
BMJ Case Rep. 2021 Feb 23;14(2):e236064. doi: 10.1136/bcr-2020-236064.
We report a case of a 70-year-old man who presented with concomitant hip fracture and stroke. Our patient underwent surgical correction of a hip fracture despite the increased perioperative and postoperative risks associated with an acute stroke. He achieved good functional outcome after surgery and subsequent rehabilitation. There are no clear guidelines on the factors to determine whether a patient with concomitant stroke and hip fracture is a good candidate for surgical hip repair. Furthermore, there is also no consensus on the appropriate timing of surgical repair for such patients. We postulate that factors such as functional status, comorbidities, type and severity of stroke will affect the decision to proceed with surgical repair, and that there is a benefit in advocating for surgery in appropriate patients by a multidisciplinary orthogeriatric care team.
我们报告了一例 70 岁男性患者,他同时患有髋部骨折和中风。尽管与急性中风相关的围手术期和术后风险增加,但我们的患者仍接受了髋部骨折的手术矫正。他在手术后和随后的康复中取得了良好的功能结果。对于同时患有中风和髋部骨折的患者,是否适合接受手术髋部修复,目前尚无明确的指南来确定相关因素。此外,对于此类患者,手术修复的适当时机也没有共识。我们推测,功能状态、合并症、中风的类型和严重程度等因素将影响是否进行手术修复的决策,并且多学科骨科护理团队提倡在适当的患者中进行手术是有益的。