A visiting 80-year old Indian with diabetes and hypertension has undergone successful total hip replacement, thanks to a team of Dubai doctors. They conducted the precarious operation that helped the man avoid multiple complications such as pulmonary embolism and even death.
The patient, Balakrishnan Pallikuth, came to Dubai with his wife Lakshmi Kutty in December last year to visit their daughter. With diabetes and high blood pressure, the octogenarian's health was already unstable.
During one of his morning walks, Pallikuth lost his balance and fell on the ground. He fractured his left hip and was rushed to the emergency room of a nearby hospital. But doctors were not able to treat him, owing to his multiple complications.
Overcoming medical challenges
Pallikuth's family then brought him to Dr Ehab Shehata, consultant orthopaedic surgeon at International Modern Hospital (IMH).
Recounting the challenging surgery, Dr Shehata told Khaleej Times: “The patient had several disadvantages. Age was not on his side and he was suffering from impending renal failure (end stage chronic renal disease) and impending heart failure. His sugar levels were in the range of 300 mgdl (milligrams per decilitre), and blood pressure was at 180/100.”
"When he came to us, I realised he was suffering from great trauma due to the left hip fracture. He was not able to walk because of the displacement and there was shorting of the left lower limb. I decided to go ahead with the surgery,” Dr Shehata added.
High-risk patient
Before initialising the perilous operation, Dr Shehata gave a realistic picture to the family. He told them that a total hip arthroplasty that Balakrishnan required had very high risks. "I informed the family that the patient had the possibility of suffering from multiple complications such as pulmonary embolism and even death,” he recalled.
Dr Shehata had to conduct minimal invasive surgery (MIS) with a small incision with only soft tissue disruption. He also used MIS technique and used a special prosthesis that was compatible with someone his age.
The doctor made sure there was minimal surgical tissue trauma and blood loss was limited to less than 150 ml blood only.
Dr Shehata said: “Prior to the surgery, I took care to stabilise the blood sugar and blood pressure. I made sure to choose a procedure which would allow such a senior patient to recover without any complications.”
The result
Balakrishna was pain-free the next morning. Following the successful surgery, he was able to stand up on his feet with the help of crutches within 24 hours.
“After two months, much to the relief of his family, he has given up the crutches and is able to walk with the help of a walking stick, and he has been progressively improving day by day,” Dr Shehata noted.
Doctor's advice
“Senior citizens need to avoid hip fractures,” cautioned Dr Shehata, adding: "They should maintain the right weight, be physically fit, and adapt to a healthy lifestyle to avoid such emergencies.”
He noted fracture of a hip joint at a senior age is very challenging to handle. The individual can suffer from pulmonary embolism, heart attack or be bed-ridden for life.
“Therefore, my advice to all people beyond 60 years of age is to be mindful of their bone health, avoid osteoporosis by undergoing bone density scans, choose the right footwear for walks, and avoid difficult terrain on their regular walks," Dr Shehata concluded.
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