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What Do These X-rays Findings Indicate?

Posted on Tue, 5 Jul 2016

Question: Dear Dr,

I want your advice on my dad case.

My dad is 85 years old who fell over 2 days ago. He has severe pain which getting better but cannot mobilizes his right leg or walk.

Would you please advised me what do you think from radiographs attached?

He suffers from prostate cancer, COPD and a controlled high blood pressure.

He smokes 5-10 a days for last 50 years.

He does not drink alcohol.

He only takes Combodart for prostate enlargement.

He started taking diclofenac and paracetamol as pain killer since he fell two days ago.

What are the treatment options for him and what is most likely his treatment will be?
What is in your opinion is the best treatment for him taking consideration his age.
What do you think if just leave him un-treated (bed rest)?

Thank you,

Kind regards,

XXXX

Answered by Dr. Dr. Praveen Tayal (1 hour later)

Brief Answer:
Do not leave un treated.

Detailed Answer:
Hello,
Thanks for posting your query.
I have seen the attached X-rays. Your father has a trochanter fracture of right femur. Considering his medical history and age, he can be put under boot and bar plaster where he needs to take a bed rest with traction for 8-10 weeks. The bone may get healed gradually over the time.
If it is left untreated then the bone may mal unite or remain un united. This can cause a chronic pain and disability and he will be bed ridden for rest of his life.
It is best to consult an orthopedician and get a boot and bar cast with traction for him.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Praveen Tayal (35 minutes later)

Thank you for your reply,
Is boot and bar plaster the only option ?
What about surgery ?

Thank you

Answered by Dr. Dr. Praveen Tayal (1 hour later)

Brief Answer:
Boot and bar is a safe option.

Detailed Answer:
Hello.
Thanks for writing again.
Boot and bar is a safe option with good results. In your father's case, surgery may be difficult considering his medical records and smoking. If anaesthetist gives a clearance then surgical fixation can be considered.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Dr. Praveen Tayal (19 minutes later)

Thank you.
Would you please tell me where the risks of the surgical option ?
Is it during the operation itself ? Or after the operation ?

Thank you

Answered by Dr. Dr. Praveen Tayal (6 minutes later)

Brief Answer:
More risk during the operation.

Detailed Answer:
In surgical treatment a major risk is during the surgery and less risk is after the surgery. Detailed general evaluation, blood tests, ECG and cardiac status needs an evaluation before the surgery.
Regards.

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Dr. Praveen Tayal (38 minutes later)

The surgeon, anaesthetist have now decided to go ahead with half hip replacement under Spinal anaesthesia. They said there is 10 % risk. They finished the operation which took about one hour. The surgeon now said the operation is successful. Is there still any risk to worry about after the operation? And are the risks now ?

I attached the x-ray for after operation.
Please tell me what the are risks now after the operation because i am still worried?
I am living the UK and my dad is Syria. That is why I am asking for second opinion .

Answered by Dr. Dr. Praveen Tayal (6 hours later)

Brief Answer:
The chance of infection is there.

Detailed Answer:
Welcome back , yes I've seen the X-ray..

There is risk of infection . Operation is successful, no need to worry much.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Praveen Tayal (8 hours later)

What are the locations of infection ? So we can take extra care ?
Any more complications apart of infection ?

Answered by Dr. Dr. Praveen Tayal (10 minutes later)

Brief Answer:
At operative side.

Detailed Answer:
Hello.
Thanks for writing again.
Infection if occur will be at operative side.Do take antibiotics ,regular dressing will help him to avoid infection.No other complication at this stage.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Dr. Praveen Tayal (5 hours later)

My dad feel tired after operation.
He was better before the operation
Is that normal ?

Would you please send me photo of boot and cast with traction

Thank you

Answered by Dr. Dr. Praveen Tayal (3 hours later)

Brief Answer:
IT IS NORMAL.

Detailed Answer:

It is due to blood lose during operation .There is no need of boot and bar now. It is for non surgical treatment only.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Arnab Banerjee