Key result
The medial approach for open reduction internal fixation of displaced supracondylar humerus fractures in children yielded significantly better excellent functional outcomes (66.7% vs 15.0%, p=0.00) compared to the posterior triceps splitting approach.
Why the study?
Elderly patients poorly tolerate the hemodynamic alterations and stress response of anesthesia and surgery, making regional anesthesia techniques with minimal hemodynamic perturbations useful.
Cohort (n=70)
No
Absolute Event Rate: 66.7% vs 15%
p-value: p=0.00
Combined regional nerve blocks can provide effective surgical anesthesia with minimal hemodynamic perturbations for hip fracture surgery in elderly patients with severe cardiac disease.
Regional anesthesia may be feasible in high-risk elderly cardiac patients; hypothesis-generating and requires prospective validation.
The hemodynamic alterations and stress response associated with anesthesia and surgery are often poorly tolerated by elderly patients. Regional anesthesia techniques are useful in the elderly as they provide excellent perioperative analgesia with minimal hemodynamic perturbations. We report the case of a 90-year-old man with valvular heart disease and severe left ventricular systolic dysfunction, who underwent dynamic hip screw fixation of fractured femur neck under combined pericapsular nerve group block, lumbar plexus block, and para-sacral sciatic nerve block. We are not aware of any previous report of the combination of these blocks used for surgical anesthesia in hip fracture surgery.
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Acharya et al. (2022) conducted a cohort in Displaced supracondylar fracture of humerus (n=70). Medial approach vs. Posterior triceps splitting approach was evaluated on Excellent functional outcome (Flynn's criteria) (p=0.00). The medial approach for open reduction internal fixation of displaced supracondylar humerus fractures in children yielded significantly better excellent functional outcomes (66.7% vs 15.0%, p=0.00) compared to the posterior triceps splitting approach.
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