Karad, Aug 28: Doctors at Sahyadri Super Speciality Hospital, Karad, A network Hospital of Manipal Hospitals successfully treated a 95–year–old woman with a severely comminuted distal femur fracture (It is a severe break near the knee in which the thigh bone has shattered into multiple pieces) following a fall at home. Despite her advanced age, underlying cardiac condition, hypertension and diabetes, the patient underwent minimally invasive fixation with intramedullary nailing. The procedure was completed in approximately 30 minutes. The minimally invasive approach helped reduce surgical stress and enabled the patient to begin her recovery at an advanced age despite multiple health challenges.
Before the accident, the patient could handle her daily tasks and move around on her own with the use of a stick. She was unable to stand or walk due to the severe fracture, and it caused severe pain and rendered her unable to stand or walk with significant displacement of the fracture fragments. Long-term immobilization was also a big worry given her age and health issues.
The patient’s poor cardiovascular condition, hypertension and diabetes made surgical and anesthetic management particularly challenging. Before proceeding, the team carried out appropriate medical and anesthetic optimization. The decision to operate was taken collectively after assessing her overall health and carefully balancing the potential benefits and risks.
Speaking about the case, Dr. Jaydeep Patil, Consultant Orthopedic and Joint Replacement Surgeon, Sahyadri Super Speciality Hospital, Karad, “The patient had a severe fracture near the knee, with the broken bone completely out of alignment. The injury caused significant pain and made it impossible for her to walk. However, her advanced age, heart condition, high blood pressure and diabetes made surgery and anesthesia more challenging. After appropriate medical and anaesthetic optimisation the medical team decided that surgery was necessary, as prolonged bed rest could lead to complications such as bedsores, pneumonia, cardiac and respiratory complications, and further loss of mobility.
Dr. Patil further said, “We performed the fracture fixation using a minimally invasive nailing technique. Compared with conventional open surgery, this approach allowed us to achieve stable fixation with limited surgical exposure and less soft-tissue disruption. Another important consideration was to keep the operative and anesthesia time as short as safely possible. The procedure was completed in approximately 30 minutes. The anesthesia team closely monitored her throughout the surgery and played an important role in safely managing her medical condition. For a 95–year–old patient with multiple comorbidities, completing the procedure in a short operative time was particularly encouraging. Our objective was not only to fix the fracture, but also to help her regain mobility and independence. and preserve the mobility and independence she had before the fall.”
Given the patient’s advanced age and underlying cardiac condition, hypertension and diabetes, anaesthetic management was a key consideration in the case. Dr. Jameer Kamthe, Consultant Anaesthetist, and Dr. Shivesh Thakur, Consultant Anaesthetist, were closely involved in her perioperative care, ensuring careful monitoring and appropriate anaesthetic management throughout the procedure.
Her successful surgical management demonstrates how careful patient selection, medical optimisation, minimally invasive techniques and coordinated surgical and anaesthesia care can help achieve favourable outcomes even in high-risk elderly patients.
After the procedure, the patient has shown encouraging recovery and is progressing towards regaining her mobility. For her family and medical team, the outcome represents more than successful fracture fixation, and it gives the possibility of helping a 95–year–old woman regain the mobility and independence she had before the fall.