Wrist fracture in a patient undergoing electroconvulsive treatment monitored using the "cuff" method.
We report on a case of a 64-year-old female patient who received electroconvulsive treatment for major depression. The patient sustained a fracture to the distal radius of the arm blocked by the "cuff" method (Smith fracture). Subsequent investigations revealed that she was suffering from osteoporosis. This case report underlines the importance of special treatment procedures for osteoporotic patients and other patient groups at risk for fractures. We recommend screening for osteoporosis in routine pre-ECT evaluation, even in younger patients, and propose not attaching the cuff to the arm in those at risk for fractures. In our patient, electroconvulsive therapy was safely continued using higher doses of succinylcholine and without the cuff method.
Baethge
Christopher
C
Department of Psychiatry, Harvard Medical School, Bipolar & Psychotic Disorders Program Mailman, Research Center McLean, Division of Massachusetts, General Hospital, 115 Mill Street, Belmont MA 02478-9106, USA. cbaethge@mclean.harvard.edu
Bschor
Tom
T
D003863:Depression / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*