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Introduction: The ongoing outbreak of novel coronavirus disease 2019 (COVID-19) is a worldwide problem. Although diagnosing COVID-19 in fracture patients is important for selecting treatment, diagnosing early asymptomatic COVID-19 is difficult. We describe herein a rare case of femoral intertrochanteric fracture concomitant with early asymptomatic novel COVID-19. Case presentation: An 87-year-old Japanese woman was transferred to our emergency room with a right hip pain after she fell. She had no fever, fatigue, or respiratory symptoms on admission and within the 14 days before presenting to our hospital, and no specific shadow was detected in chest X-ray. However, chest computed tomography (CT) was performed considering COVID-19 pandemic, and showed ground-glass opacities with consolidation in the dorsal segment of the right lower lung field. Then, qualitative real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) was carried out and turned out to be positive. She was diagnosed right femoral intertrochanteric fracture with concomitant COVID-19 infection. Conservative treatment was applied to the fracture due to infection. After admission, fever and oxygen demand occurred but she recovered from COVID-19. Throughout the treatment period, no cross-infection from the patient was identified in our hospital. Conclusion: This case highlights the importance of considering chest CT as an effective screening method for infection on hospital admission in COVID-19-affected areas, especially in trauma patients with early asymptomatic novel COVID-19.

Introduction: The ongoing outbreak of novel coronavirus disease 2019 (COVID-19) is a worldwide problem. Although diagnosing COVID-19 in fracture patients is important for selecting treatment, diagnosing early asymptomatic COVID-19 is difficult. We describe herein a rare case of femoral intertrochanteric fracture concomitant with early asymptomatic novel COVID-19. Case presentation: An 87-year-old Japanese woman was transferred to our emergency room with a right hip pain after she fell. She had no fever, fatigue, or respiratory symptoms on admission and within the 14 days before presenting to our hospital, and no specific shadow was detected in chest X-ray. However, chest computed tomography (CT) was performed considering COVID-19 pandemic, and showed ground-glass opacities with consolidation in the dorsal segment of the right lower lung field. Then, qualitative real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) was carried out and turned out to be positive. She was diagnosed right femoral intertrochanteric fracture with concomitant COVID-19 infection. Conservative treatment was applied to the fracture due to infection. After admission, fever and oxygen demand occurred but she recovered from COVID-19. Throughout the treatment period, no cross-infection from the patient was identified in our hospital. Conclusion: This case highlights the importance of considering chest CT as an effective screening method for infection on hospital admission in COVID-19-affected areas, especially in trauma patients with early asymptomatic novel COVID-19.

旭川医大整形外科同門を対象とした大腿骨頚部・転子部骨折の診断，治療につきアンケート調査を行った.その結果のうち術前牽引，荷重時期，人工骨頭のセメント使用・非使用につき，日本整形外科学会の診療ガイドラインの内容と照らし合わせ考察した.術前牽引については，「原則として牽引する」は頚部・転子部骨折とも半数を超え予想以上に非牽引派が多かった.これには牽引を不要とする論文やガイドラインの影響が考えられたが，その適応は慎重であるべきである.荷重時期については，頚部骨折，転子部骨折ともに「原則として部分荷重または免荷期間を設けている」が約半数を占め，早期荷重可能な症例も中に含まれていることが懸念された.人工骨頭のセメント使用は約7割であり，セメント使用による死亡例も報告された.ガイドラインではセメント使用・非使用のいずれも可とされているが，それぞれの特徴を知り，合併症への対策を講じることが重要である

As life expectancy rises, the number of elderly patients who are potential candidates for surgery is also increasing rapidly. We reported the eldest male patient, who was 107-year-old, with femoral intertrochanteric fracture that we have managed with osteosynthesis under spinal anaesthesisa. The fracture was classified as type 1, group 3 under the Evans's classification and was fixed with a compression hip screw. The patient was able to walk with the assistance of a nurse without pain after surgery. He died from pneumonia 11 months later. Our experience suggests that surgery for hip fractures in centenarians poses a challenge; successfully meeting this challenge requires optimal anaesthesia.