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What Do These Lab Reports For Femur Fracture Indicate?

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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 and 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,
doctor
Answered by Dr. Aashish Raghu (15 minutes later)
Brief Answer:
Intertrochanteric femur fracture. Surgery vs immobilisation.

Detailed Answer:
Hi there.

Thanks for the query.

Your Dad has fracture of the intertrochanteric region.

The treatment options available are internal fixation with implant, hip replacement and immobilisation in a boot.

Since he has many comorbid conditions, he may find difficulty in getting fit for surgery.

This fracture can also heal by immobilisation in a boot kept in external rotation.

The only drawback is that prolonged immobilisation can cause bed sores and also increase chance of mortality due to department vein thrombosis and other factors.

Best option will be to get it operated and get him moving about but only if he can get fit for surgery. The Anaesthetist will be able to comment if he will be fit to endure surgery.

I hope I have answered your query.

I will be available to answer your follow up queries.

Regards,

Dr. Aashish Raghu
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
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Follow up: Dr. Aashish Raghu (1 hour later)
thank you for your reply.
Would you please tell what are the risks of operation ? And when those risks might happen , during or after the operation ?
Thank you
doctor
Answered by Dr. Aashish Raghu (5 hours later)
Brief Answer:
Heart and lung failure, need for ICU admission, fluctuating blood pressure

Detailed Answer:
Risks include difficulty in inducing and also coming out of Anaesthesia. Heart of lung failure can occur. Need of ICU admission for proper monitoring dude to COPD and other comorbid conditions.

The complications can occur both during and after surgery but most commonly after surgery.


If the Anaesthetist gives clearance for fitness for surgery after advising for certain investigations, then usually the complications are preventable and manageable.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Aashish Raghu (6 hours later)
How long should my dad stay in hospital after operation to prevent those complications, how many days/weeks roughly?
doctor
Answered by Dr. Aashish Raghu (25 hours later)
Brief Answer:
Usually 7 to 10 days

Detailed Answer:
Usually the patient is kept for observation for about 7 to 10 days. The stitches or surgical staples of the surgery area usually removed between day 7 to 12.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Aashish Raghu (5 hours later)
I am posting this again to find an unbiased answer to my dad death.
He dies at home 9-10 days after the operation:
1. The operation went well and was in good health after the operation (just tired).
2. The surgeon discharged him after 3 days following the operation, saying everything is ok.
3. His health getting worse and started having asthma like symptoms.
4. A local heart specialist saw him 5 days after discharge and advised to have oxygen machine at home which done.
5. He died after 7 days of discharge.

Please give me some detail about what exactly happened and why he died?

Also could the conservative treatment (boot & bar/ traction) have saved my dad life? Was it guaranteed to save his life without complications ?

Kind regards

doctor
Answered by Dr. Aashish Raghu (16 hours later)
Brief Answer:
Both survey and boot and bar have complications. No guarantee to save life

Detailed Answer:
I am sorry to hear about your Dad. My condolences are with you.

If after surgery he developed shortness of breath, it could mean he may have formed a clot which had travelled to the lungs. This is called Pulmonary embolism. Also aggravation of COPD can cause the same.

The boot and bar may have prevented surgical complications but can cause chronic problems like bed sores and clot formation in the limb.

There is no guarantee of any treatment that was better for him. It all depends on his fitness for surgery and his ability to withstand surgery or prolonged immobilisation without surgery.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
Answered by
Dr.
Dr. Aashish Raghu

Orthopaedic Surgeon

Practicing since :2011

Answered : 5482 Questions

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What Do These Lab Reports For Femur Fracture Indicate?

Brief Answer: Intertrochanteric femur fracture. Surgery vs immobilisation. Detailed Answer: Hi there. Thanks for the query. Your Dad has fracture of the intertrochanteric region. The treatment options available are internal fixation with implant, hip replacement and immobilisation in a boot. Since he has many comorbid conditions, he may find difficulty in getting fit for surgery. This fracture can also heal by immobilisation in a boot kept in external rotation. The only drawback is that prolonged immobilisation can cause bed sores and also increase chance of mortality due to department vein thrombosis and other factors. Best option will be to get it operated and get him moving about but only if he can get fit for surgery. The Anaesthetist will be able to comment if he will be fit to endure surgery. I hope I have answered your query. I will be available to answer your follow up queries. Regards, Dr. Aashish Raghu