Review

What Should an Orthopaedic Surgeon do to Avoid Thyroid Storm?

10.5222/otd.2016.1043

  • Betül Ekiz Bilir
  • Bülent Bilir
  • Mehmet İşyar
  • Ayşe Tuba Tonbul
  • Kadir Öznam
  • İbrahim Yılmaz
  • Selami Çakmak

Received Date: 22.02.2015 Accepted Date: 27.11.2015 Eur Arc Med Res 2016;32(2):99-104

Objective:

Thyroid storm can be seen in many situations like radiologic imaging with non-ionic contrast agents, trauma that causes muscle destruction, rib fractures, septic arthritis, pelvic osteochondromatosis, during or after arthroscopic synovectomy. Thyroid storm may be triggered in thyrotoxic patients who were operated before achieving euthyroid, in the elderly population suffering from cardiac problems and in cases of orthopedic implant surgery applied mostly to women. In this article, we aimed to discuss how to recognize the thyroid storm in planned or emergency orthopaedic operations and management of this situation.

Methods:

Without language restriction in this paper, the electronic databases; The Cochrane Collaboration The Cochrane, The Cochrane Library (Issue 2 of 12, Jan. 2015), Ovid MEDLINE (Jan 1924 to Jan Week 1 2015), ProQuest, US National Library of Medicine National Institutes of Health (NLM) and PubMed dating from Jan 1924 to Jan. 2015, were searched for comparative experimental studies using the terms: “or”, “and”. Online literature searches were conducted using the keywords “thyrotoxicosis”, “thyroidstorm”, “radioactive iodine treatment”, and “orthopaedic surgery ” in combinations.

Results:

In the obtained articles two were related with the study criteria.

Conclusion:

In the thyroid storm during the discharge stage if there is no contraindication, cases using propylthiouracyl must switch to methimazole which is less hepatotoxic.

Keywords: orthopaedic surgery, radioactive iodine treatment, thyroid storm, thyrotoxicosis