Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
Int J Environ Res Public Health. 2023 Feb 23;20(5):4004. doi: 10.3390/ijerph20054004.
Electroconvulsive therapy (ECT) is an effective treatment for refractory major depressive disorder with suicidal ideation. The most common adverse medical events are transient retrograde amnesia, falls and pneumonia. Hip fractures, associated with high-energy trauma by convulsions, were occasionally reported in western countries, in the period before the COVID-19 pandemic. Strict COVID-19 regulations influenced the course and further investigation of the treatment of post-ECT complications. A 33-year-old man, previously diagnosed with major depressive disorder, had a history of nine successful sessions of ECT treatment for depression five years ago. He was hospitalized again for 12 sessions of ECT for recurrent depression. Unfortunately, an ECT-induced right hip-neck fracture was noted after the ninth session of ECT, in March 2021. After receiving close reduction and internal fixation of the right femoral neck fracture, with three screws, his original daily function was restored. His treatment was regularly followed up at the outpatient clinic for 20 months; he achieved partial remission with three combined antidepressants. This case of ECT-induced right hip-neck fracture informed psychiatric staff to be aware of this rare adverse complication and ensure its appropriate management, especially during the COVID-19 pandemic.
电抽搐治疗（ECT）是治疗有自杀意念的难治性重度抑郁症的有效方法。最常见的不良医学事件是短暂性逆行性遗忘、跌倒和肺炎。在 COVID-19 大流行之前的西方国家，偶尔有报道称髋部骨折与抽搐引起的高能量创伤有关。严格的 COVID-19 规定影响了 ECT 后并发症治疗的过程和进一步调查。一名 33 岁男子，此前被诊断为重度抑郁症，五年前曾因抑郁症接受过九次成功的 ECT 治疗。他因复发性抑郁症再次住院接受了 12 次 ECT。不幸的是，2021 年 3 月，在第九次 ECT 后发现右侧股骨颈骨折。在接受右股骨颈骨折闭合复位和三根螺钉内固定后，他恢复了原来的日常功能。他的治疗在门诊定期随访了 20 个月；他服用三种联合抗抑郁药后达到部分缓解。这例 ECT 引起的右侧股骨颈骨折提醒精神科工作人员注意这种罕见的不良并发症，并确保其得到适当的管理，尤其是在 COVID-19 大流行期间。
