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Pulmonary Interstitial Vasculitis

Pulmonary Interstitial Vasculitis

myorthoevidence.com/Podcast/Show/30

Experience from 2 months of treating Covid19 patients in Italia.
All the elderly trauma patients arriving at the hospital have viral pulmonitis on the Xray or scan, ever when they test negative.
On autopsies, they found out they tend to develop pulmonary interstitial vasculitis and are more prone to venous thrombosis and pulmonary embolism.

So you are either stucked proceeding with being agressive and going forward with an extensive femur fracture surgery and they might have pulmonary complications or not being agressive and they will not be able to walk ever again.

FISHEV | 09. April 2020

"So you are either stucked proceeding with being agressive and going forward with an extensive femur fracture surgery and they might have pulmonary complications or not being agressive and they will not be able to walk ever again."

Spinals at least keep physiological stress from pain down during surgery, epidural maybe for longer term pain. Use LMA for breathing assist if necessary, COPD patient. Even then the risks are so high and so many co-morbidities for the fall fractures so common in the elderly.

You tell them the risks, they make the choice.

Our criteria now is can they wait 90 days. Having a hip pinning and then getting Covid-19 along with existing conditions and age, hate to see that survival stats on that.

SCCRENDO | 09. April 2020

I suspect you should treat femoral neck fractures as you did prior to Covid. You need to take all the appropriate measures as before. However the overall incidence in the elderly is still not necessarily that high in the elderly at this point. Operating on the elderly as stated is more risky than in the young. And this adds to the potential risk. But the question is does it truly raise the risk high enough that you would defer surgery.