The patient tolerated the procedure well without complications. At the end of the surgery, the blood loss was 50 mL, and she was transferred to the recovery room in stable condition. This case was done under spinal anesthesia. Dressing was placed of Xeroform, 4 x 4, ABD, soft bulky dressing, and a sponge, tape dressing. Subcutaneous tissue was closed with interrupted inverted 2-0 Vicryl sutures. Deep fascia was closed with interrupted 0-Vicryl figure-of-eight sutures. The fracture was reduced nicely in an appropriate position and the hardware appeared stable.Ĭopious amounts of normal saline were used to irrigate off the wound. Final C-arm fluoroscopy views were taken. Hip fractures can occur either due to a break in the femoral neck. The two inferior screws were 85 mm in length, partial thread, 60 mm 7.0 screws, and the superior one was 80 mm in length. The lesser trochanter projects from the base of the femoral neck on the back of the thighbone. Cannulated drills were then used to open up the lateral cortex, and the appropriate size screws were then placed in a cannulated fashion. Each of them were measured and checked in the AP and lateral planes. Three guidewires were placed in a triangular pattern, two inferior and one superior. C-arm fluoroscopy showed appropriate placement of the guidewire. An osteotome and a periosteal elevator were used to remove all muscle attachments from the proximal lateral femur. The vastus lateralis was also dissected through and reflected anteriorly. The fascia lata was opened and reflected anteriorly. Dissection was continued down to the fascia. Routine sterile draping technique was used.Ī lateral incision was made over the left hip measuring about 2 inches. The entire left hip region was prepped and draped in a sterile fashion with a double DuraPrep scrub. The left lower extremity was placed in gentle traction and internal rotation. Once this was completed, she was placed in the supine position on the fracture table. Spinal anesthesia was induced without complication. The patient was placed in a lateral decubitus position. Once the patient was back, she was transferred from the OR stretcher to the operating table without complications. The patient was taken to the operating room for a left hip hemiarthroplasty.ĭESCRIPTION OF OPERATION: The patient was given 1 gram of Rocephin IV piggyback prior to coming back to the operating room. INDICATION FOR OPERATION: This is a (XX)-year-old female with multiple medical problems who suffered a fall a week ago resulting in an impacted left femoral neck fracture. OPERATION PERFORMED: Open reduction and internal fixation, left femoral neck fracture. POSTOPERATIVE DIAGNOSIS: Left femoral neck fracture, impacted valgus position. PREOPERATIVE DIAGNOSIS: Left femoral neck fracture, impacted valgus position.
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