Published: 2018-12-25

Trousseau’s sign in orthopedic: a rare sequelae of inadequate postoperative pain management

Hriday P. Acharya, Zulfikar M. Patel, Nirav K. Mungalpara, Meet S. Mehta


Background: Pain management in orthopedic is very crucial matter to handle, which is many a times not managed properly and that leads to various medical complications to the patients. Trousseau sign of latent tetany is a medical sign observed in patients with low calcium. This is the first and one of a kind case series describing the development and pathogenesis of Trousseau sign in orthopedics.

Methods: This is a case series of 5 patients with lower limb fractures who underwent surgery. All these patients developed Trousseau's sign in immediate postoperative period. All the patients were investigated and were diagnosed with respiratory alkalosis. They were managed with closed bag ventilation which relieved the symptoms.

Results: Here we put forward a direct physiological and psychological relation between a low pain threshold and associated hyperventilation with lead to development of Trousseau's sign in our patients. So, next time in postoperative round, if we see patient hyperventilating and complaining about fixed hand’s position, do not start calcium gluconate drip immediately, it may be due to respiratory alkalosis, then closed bag ventilation would be suffice.

Conclusions: Trousseau’s sign seen postoperatively in Orthopedics may be commonly due to inadequate pain management rather than altered calcium metabolism.



Pain management, Fractures, Trousseau's sign, Calcium metabolism, Respiratory alkalosis

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