{"title":"紧急股骨粗隆间骨折修复术中黏液性水肿昏迷的识别与麻醉处理。","authors":"Arusa Macnojia, Marlene Lopez, Jamal Hasoon, Anvinh Nguyen","doi":"10.52965/001c.143086","DOIUrl":null,"url":null,"abstract":"<p><p>Myxedema coma is a rare, life-threatening complication of severe, long-standing hypothyroidism, often precipitated by physiological stress such as infection, trauma, or surgery. Perioperative presentations of myxedema coma are especially uncommon. This case report describes a 71-year-old male with a history of poorly controlled hypothyroidism who underwent emergent surgical fixation of a traumatic left intertrochanteric femur fracture who developed intraoperative myxedema coma. Timely diagnosis and intervention-including intravenous thyroid hormone replacement, corticosteroids, hemodynamic support, and close anesthetic management were crucial to optimizing the patient's outcome. This report highlights the critical role of anesthetic management in myxedema coma cases, emphasizing the importance of endocrine and hemodynamic support. Furthermore, it promotes multidisciplinary coordination when managing endocrinological emergencies in high-risk surgical patients.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"17 ","pages":"143086"},"PeriodicalIF":2.1000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442890/pdf/","citationCount":"0","resultStr":"{\"title\":\"Intraoperative Recognition and Anesthetic Management of Myxedema Coma During Emergent Intertrochanteric Femur Fracture Repair.\",\"authors\":\"Arusa Macnojia, Marlene Lopez, Jamal Hasoon, Anvinh Nguyen\",\"doi\":\"10.52965/001c.143086\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Myxedema coma is a rare, life-threatening complication of severe, long-standing hypothyroidism, often precipitated by physiological stress such as infection, trauma, or surgery. Perioperative presentations of myxedema coma are especially uncommon. This case report describes a 71-year-old male with a history of poorly controlled hypothyroidism who underwent emergent surgical fixation of a traumatic left intertrochanteric femur fracture who developed intraoperative myxedema coma. Timely diagnosis and intervention-including intravenous thyroid hormone replacement, corticosteroids, hemodynamic support, and close anesthetic management were crucial to optimizing the patient's outcome. This report highlights the critical role of anesthetic management in myxedema coma cases, emphasizing the importance of endocrine and hemodynamic support. Furthermore, it promotes multidisciplinary coordination when managing endocrinological emergencies in high-risk surgical patients.</p>\",\"PeriodicalId\":19669,\"journal\":{\"name\":\"Orthopedic Reviews\",\"volume\":\"17 \",\"pages\":\"143086\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-09-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442890/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Orthopedic Reviews\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.52965/001c.143086\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Orthopedic Reviews","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.52965/001c.143086","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Intraoperative Recognition and Anesthetic Management of Myxedema Coma During Emergent Intertrochanteric Femur Fracture Repair.
Myxedema coma is a rare, life-threatening complication of severe, long-standing hypothyroidism, often precipitated by physiological stress such as infection, trauma, or surgery. Perioperative presentations of myxedema coma are especially uncommon. This case report describes a 71-year-old male with a history of poorly controlled hypothyroidism who underwent emergent surgical fixation of a traumatic left intertrochanteric femur fracture who developed intraoperative myxedema coma. Timely diagnosis and intervention-including intravenous thyroid hormone replacement, corticosteroids, hemodynamic support, and close anesthetic management were crucial to optimizing the patient's outcome. This report highlights the critical role of anesthetic management in myxedema coma cases, emphasizing the importance of endocrine and hemodynamic support. Furthermore, it promotes multidisciplinary coordination when managing endocrinological emergencies in high-risk surgical patients.
期刊介绍:
Orthopedic Reviews is an Open Access, online-only, peer-reviewed journal that considers articles concerned with any aspect of orthopedics, as well as diagnosis and treatment, trauma, surgical procedures, arthroscopy, sports medicine, rehabilitation, pediatric and geriatric orthopedics. All bone-related molecular and cell biology, genetics, pathophysiology and epidemiology papers are also welcome. The journal publishes original articles, brief reports, reviews and case reports of general interest.