Orthopedic surgery for chronic hemodialysis patients.

The population of patients with renal failure requiring long-term dialysis is large and growing. Over the last 6 years, we have done 55 operations among 42 patients treated with chronic hemodialysis. Surgical disorders in these patients were carpal tunnel syndrome (20 cases), femoral head necrosis (7 cases), medial fracture of the femoral neck (7 cases) and others (8 cases). We report our experiences concerning the care given before, during and after surgery to patients on maintenance hemodialysis. We emphasize the importance of the complications of hyperkalemia, sepsis, hemorrhage, anemia and delayed wound healing. There must be careful observation for these complications and aggressive nutritional, hematologic and metabolic intervention to avoid preventable operative complications. Using FOY ®, we can reopen hemodialysis on the first postoperative day. Intravenous regional anesthesia is useful for the operation of an upper extremity.