X-Ray-Guided Spinal Anaesthesia for a Complex Patient Undergoing Intramedullary Fixation of Atypical Subtrochanteric Femur Fracture

While current evidence suggests that the choice between spinal and general anaesthesia for neck of femur fracture patients does not significantly affect overall mortality or most major perioperative outcomes, there remains a need for the trauma anaesthetist to tailor their technique to the individual patient. We report on the use of a C-arm fluoroscopy-guided spinal anaesthetic in a neck of femur fracture patient who was at high risk for general anaesthesia and had background bilateral sciatica, a condition increasing the risks of neurological injury associated with procedural failure and multiple attempts at a landmark approach. Chronic pain anaesthetists with expertise in C-arm fluoroscopy for spinal interventions are well placed to train colleagues and widen competence in this technique.