PMC10119647_01
Radiographic images of the left femur: (a) obtained at our emergency room showing a left ipsilateral femoral neck and shaft fracture; (b) plain radiographs of the left femur taken the day after surgery.
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A Pauwels classification type 3 femoral neck fracture and ipsilateral shaft fracture was found in the left femur after radiograph assessment (Figure 1(a)). To manage the shaft and neck fracture of the femur, IM nail fixation with cephallomedullary screws was done after closed reduction (Figure 1(b)). The surgery was completed under standard respiratory and hemodynamic parameters, and postoperative radiographs displayed acceptable reduction and fracture fixation (Figure 1(b)).
Radiographic images of the chest: (a) chest radiographs obtained at our emergency room indicates no active pulmonary abnormalities; (b) obtained on POD2, reveals bronchopneumonia with multiple patch consolidation in both lungs; (c) ARDS can be seen on POD3; (d) resolved lesion on POD 14.
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The patient was admitted to an isolated ward and treated with remdesivir (100 mg by IV) every 24 h and piperacillin/tazobactam (4.5 g by IV) 3 times daily. Immediately after taking the test, the patient showed no sign of COVID-19 symptoms such as a fever, cough, fatigue, or pulmonary lesion on a radiograph (Figure 2(a)). The patient had no previous treatment history, comorbidities, family history, allergy history, and was physiologically stable upon admission. Following chest radiograph examination, bronchopneumonia in both lungs with multiple patch consolidation was found (Figure 2(b)) and high flow nasal oxygenation (HFNO) was initiated. One day after CPAP therapy, chest radiographs showed aggravated pneumonia and the patient was diagnosed with ARDS using Berlin's definition (Figure 2(c)). The patient was discharged from the hospital on day 14 after surgery (Figure 2(d)).