The Japanese Journal of Clinical Dialysis Vol.26 No.6(2-5)

Theme Orthopedic Diseases Seen in Maintenance Dialysis Patients -- Surgical Indication and Non-indication
Title Fractures in hemodialysis patients
Publish Date 2010/06
Author Ryo Imai Department of Orthopaedic Surgery, Tojinkai Hospital
Author Masaya Nishida Department of Urology, Tojinkai Hospital
Author Noriyuki Iwamoto Department of Urology, Tojinkai Hospital
Author Toshihiko Ono Department of Urology, Tojinkai Hospital
[ Summary ] In this report, a guideline stating "how dialysis specialists should examine and treat fractures in dialysis patients" is illustrated. It is necessary for dialysis specialists who examine patients with fractures to first provide primary care such as treatment for shock, confirmation of bone merger breakdown, diagnosis of fractures, treatment of fractures in pars, and measures to control bleeding. The first recommended treatment should be external fixation with a splint, followed by cast application soon after the fracture. Secondly, consultation with an orthopedist concerning a treatment plan for simple fractures with derangement is required. Next, the dialyzer should have heparin sodium replaced with nafamostat mesilate, Finally, when the danger of complications from vascular occlusion is high, withdrawal of antiplatelet drugs, in relation the risk benefit ratio must be taken into consideration.
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