The Department of Trauma, Orthopedics and Neurology at Hoan My Danang Hospital has successfully carried out hemiarthroplasty in a 102 year-old woman in Quang Tri. Hoan My Da Nang Hospital has previously performed the same hemiarthroplasty procedures with success in many patients over 100 years old.

The patient, an elderly woman, NTT (102 years old, Hai Lang, Quang Tri) was hospitalised on 6 February 2021. She was in pain and had lost the movement in her left thigh. At noon on 6 February, while walking, Mrs. T accidentally fell. It was not an unusual fall, but she hit the floor with her hip, so she had pain in her left leg. At the hospital, after conducting some tests and a CT, the doctor determined that the woman had a broken upper femur head and that she qualified for hemiarthroplasty.

Ha Nguyen Minh Quang, M.D., MSc., Head of the Department of Trauma, Orthopedics and Neurology at Hoan My Danang Hospital says: “It is a difficult case, because the patient is elderly, with many accompanying internal diseases. If the joint replacement surgery was not performed, it would be difficult to move or sit, and it could cause many complications such as pneumonia, urinary tract infection, etc. Before the surgery, the surgical team must carefully prepare both the staff and the equipment to operate adequately on the patient, even in the worst situations”.

The most difficult factor in this type of surgery is the process of anesthesia and resuscitation, and also complications during the operation. The doctor who conducted the echocardiography for the patient detected mitral valve thickening and decreased contractility. With reference to heart failure, the injection of an anesthetic during surgery can easily cause severe heart failure in the patient. The possibility of the patient dying during or after surgery is quite high.

Nguyen Van Hac, M.D., MSc., Head of the Department of Anesthesia and Resuscitation, Hoan My Danang Hospital says: “All anesthetics have the function of reducing the contractility of the heart muscle. In that case, the force of the patient’s heart muscle contraction is weak, so the anesthesia/resuscitation process for the patient must apply the highest standard methods and techniques that are normally only used in heart surgery, such as invasive arterial catheter insertion, central venous catheter placement for continuous hemodynamic monitoring, continuous use of vasopressors during surgery to avoid heart failure, and monitoring during treatment. After surgery, continue to maintain the vasomotor condition until the hemodynamics become stable”.

The surgery was successful after 45 minutes; the patient underwent hemiarthroplasty with no postoperative complications. She was discharged from the hospital after 14 days of treatment.

Anesthesia is one of the most important and indispensable processes, not only for Mrs. NTT, but for surgery in general. The anesthesiologist is responsible for both anesthesia and the overall management of surgery, as well as maintaining the patient in the best condition to ensure safety throughout the surgery. The greatest goal of anesthesia/resuscitation is to ensure the safety of the patient during and after surgery. 

The team of doctors and technicians specialised in anesthesia at Hoan My Danang Hospital has more than 20 years of experience and is responsible for safety in the operating room. Until now, the Anesthesia and Resuscitation Team at Hoan My Danang Hospital has participated in and ensured the safety of more than 1500 open-heart surgeries and thousands of musculoskeletal, neural, cranial, and cesarean surgeries at the hospital.

The Anesthesia and Resuscitation Department at Hoan My Da Nang Hospital is equipped with modern, computerised devices to closely monitor patients, to give respiratory and cardiological support throughout the surgery and the postoperative period until the patient regains consciousness and completely recovers. Many modern and safe anesthesia techniques have been applied to help patients have a smooth anesthesia experience and regain consciousness quickly, without any fatigue or discomfort. 

Hoan My Danang Hospital