A Catastrophic Cascade of Postoperative Complications Following Hemiarthroplasty for Femoral Neck Fracture in a Middle-Aged Patient With Schizophrenia.

Eustathios Kenanidis,Nikolaos Milonakis,Evangelia M Tsapakis,Eleftherios Tsiridis,Sofia-Chrysovalantou Zagalioti

doi:10.7759/cureus.9044

Eustathios Kenanidis, Nikolaos Milonakis + Show 3 more

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https://doi.org/10.7759/cureus.9044

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Journal: Cureus	Publication Date: Jul 7, 2020
Citations: 1	License type: cc-by

Affiliation: Papageorgiou General Hospital

Abstract

The treatment of a patient with schizophrenia suffering a subcapital hip fracture may be challenging, mainly due to the high risk of postoperative medical and surgical complications. Mechanical complications from the implant are also frequently encountered following hip arthroplasty in patients with schizophrenia. We report the case of a 57-year-old male patient with schizophrenia who underwent hip hemiarthroplasty for a displaced femoral neck fracture. During the initial postoperative period, the patient developed a cascade of surgical and mechanical complications, leading to multiple revision procedures and a suboptimal outcome. The ideal type of treatment of patients with schizophrenia with subcapital hip fracture is still missing. It is, therefore, important to highlight the high risk of postoperative complications in patients with schizophrenia who present with subcapital fractures subsequently treated with hemiarthroplasty.

Highlights

Schizophrenia is a chronic, severe mental illness characterized by relapsing episodes of psychosis, during which reality is interpreted in an abnormal way [1]
We report the case of a 57-year-old male patient with schizophrenia who underwent hip hemiarthroplasty for a displaced femoral neck fracture
Important to highlight the high risk of postoperative complications in patients with schizophrenia who present with subcapital fractures subsequently treated with hemiarthroplasty

Summary

Introduction

Schizophrenia is a chronic, severe mental illness characterized by relapsing episodes of psychosis, during which reality is interpreted in an abnormal way [1]. Following trauma and elective orthopaedic procedures, patients with schizophrenia demonstrated a greater risk of postoperative mechanical implant and surgical complications with longer hospital stays compared to patients with other psychiatric comorbidities or healthy controls [10,11]. We here report the case of a 57-year-old male patient with schizophrenia who suffered a displaced femoral neck fracture and was initially treated with hip hemiarthroplasty. How to cite this article Kenanidis E, Zagalioti S C, Milonakis N, et al (July 07, 2020) A Catastrophic Cascade of Postoperative Complications Following Hemiarthroplasty for Femoral Neck Fracture in a Middle-Aged Patient With Schizophrenia. The patient was readmitted to our orthopaedic department complaining of acute left hip pain and inability to bear weight. The patient was discharged back to a long-term mental health facility, being able to sit, but he could not weight-bear on the left side, as expected

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